Ulnar Artery Aneurysm with Ipsilateral Radial Artery Occlusion: A Case Report and Literature Review

Ulnar artery aneurysms (UAAs) are rare vascular lesions, most commonly associated with repetitive hand trauma and hypothenar hammer syndrome. Simultaneous involvement of both the ulnar and radial arteries is exceptionally uncommon. We report the case of a 61-year-old female patient with a true distal UAA in the dominant hand and concomitant ipsilateral radial artery occlusion, possibly associated with prolonged occupational repetitive trauma from sewing machine use. The patient presented with a progressively enlarging pulsatile wrist mass and sensory symptoms in the ulnar nerve distribution. Computed tomography angiography demonstrated a fusiform UAA and complete radial artery occlusion. Because the ulnar artery represented the only patent major arterial inflow to the hand, aneurysm excision and direct end-to-end spatulated reconstruction were performed under local anesthesia. At 2-year follow-up, the patient remained asymptomatic, with a patent reconstruction and preserved hand perfusion. This case highlights the importance of arterial reconstruction in dual-vessel disease.