Idiopathic True Aneurysms of the Brachial Artery: A Short Case Series and Scoping Review

Background: Brachial artery aneurysms are a rare entity occurring sporadically at all ages. Common causes are trauma, infection, connective tissue disorders, genetic syndromes, immunosuppression, and a history of arteriovenous vascular access. Pseudoaneurysms are mainly of traumatic or iatrogenic origin. Idiopathic true brachial artery aneurysms are even scarcer, attributed to inherited susceptibility for aneurysm formation or to atherosclerosis. Due to the rarity of these aneurysms, we report our experience along with a current literature review. Methods: A retrospective search was conducted in the Vascular Surgery Department database of a tertiary referral center for vascular surgery, covering procedures from January 1991 to October 2025. Patients were included if they had undergone idiopathic true brachial artery aneurysm repair. Clinical records, operative details, imaging studies, and follow-up data were reviewed. We additionally provide a literature review regarding clinical presentation, signs, pathophysiology, diagnosis, and treatment of these aneurysms. Results: Amongst all procedures performed for aneurysmal repair, in the searched period, we identified three patients who met these criteria. All three underwent successful elective operations. Individual characteristics of the retrieved cases are reported. Conclusions: The open repair of true idiopathic brachial artery aneurysms is a technically simple approach that leads to satisfactory outcomes. Endovascular therapy is technically unfavorable in this type of aneurysm.