Vascular surgery department, Tauranga Hospital, Tauranga, New Zealand.
Vascular. 2024 Aug;32(4):892-895. doi: 10.1177/17085381231164453. Epub 2023 Mar 13.
Ulnar artery aneurysms are rare with less than 250 previously reported in the literature. Most ulnar artery aneurysms occur distally near the palmar arch (hypothenar hammer syndrome). There are five previous reports of true ulnar artery aneurysms in the forearm; however, there are no reported cases of ulnar artery aneurysms proximal to the cubital fossa.
An 87-year-old man presented with pain and a rapidly progressive median nerve palsy with a pulsatile mass in the arm. Duplex ultrasound showed an aneurysm of what was thought to be the brachial artery. CT angiography shows a high bifurcating brachial artery and true aneurysm of the ulnar artery proximal to the cubital fossa. The artery was explored and the decision was made to excise the aneurysm and ligate the artery. The patient's symptoms improved and full function was regained.
This is a rare case of such a diagnosis in the absence of a history of arterial puncture or trauma. This case demonstrates the value in obtaining detailed imaging in the work-up to aid operative decision making. We highlight the thought processes on the table in our approach to this aneurysm and report a favourable post-operative outcome at follow up.
尺动脉动脉瘤较为罕见，文献中报道的病例不足 250 例。大多数尺动脉动脉瘤发生在靠近掌弓（小鱼际锤状指综合征）的远端。前臂曾有 5 例真性尺动脉动脉瘤的报道，但在肘窝近端尚无尺动脉动脉瘤的报道。
一名 87 岁男性因手臂疼痛和进行性正中神经麻痹伴搏动性肿块就诊。双功能超声显示肱动脉处有一个动脉瘤，考虑为肱动脉。CT 血管造影显示高位分叉肱动脉和肘窝近端尺动脉真性动脉瘤。对动脉进行探查，决定切除动脉瘤并结扎动脉。患者症状改善，功能完全恢复。
在没有动脉穿刺或外伤史的情况下，这是一个罕见的诊断病例。该病例表明，在术前检查中获取详细的影像学资料有助于辅助手术决策。我们强调了在处理该动脉瘤时手术台上的思维过程，并报告了随访时的良好术后结果。
