Abdulrahim Omer, Khalil Bassam Abdulhailm, Alenazi Shahad Farhan, Alanezi Tariq, Al-Omran Mohammed
Department of Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
College of Medicine, King Saud University, 11322 Riyadh, Saudi Arabia.
Int J Surg Case Rep. 2024 Oct;123:110289. doi: 10.1016/j.ijscr.2024.110289. Epub 2024 Sep 14.
Axillary artery aneurysms are rare vascular conditions that can present with various clinical manifestations, including neurological deficits and vascular compromise. While the underlying pathophysiology remains complex and multifactorial, potential associations with trauma, arteriovenous fistula formation, and atherosclerosis have been reported.
Two male patients, aged 33 and 38, with a history of kidney transplantation and previous arteriovenous fistula (AVF) presented with symptoms of upper limb ischemia and neurological compromise. Imaging revealed large axillary artery aneurysms. Open surgical repair was performed for both cases. Two weeks after discharge, one patient showed good pronation and supination with mildly limited extension. The other patient's wrist drop gradually improved with physiotherapy.
Multifactorial pathophysiology encompassed altered blood flow dynamics, inflammation, and the underlying vascular pathology. Chief complaints and prior vascular interventions contributed. Open surgical repair was preferred to endovascular approaches, achieving favorable outcomes.
Axillary artery aneurysms in patients with a history of AVF are rare but potentially serious complications. The cases highlight the complexity of axillary artery aneurysms and the need for careful evaluation and surgical intervention This strategy is crucial to prevent potential complications and optimize patient outcomes. Further research is needed to elucidate the precise pathophysiology and the potential association between AVF and the subsequent development of axillary artery aneurysms. Increasing awareness among surgeons could enable earlier detection of aneurysms, thereby reducing the risk of complications.
腋动脉瘤是一种罕见的血管疾病，可表现出多种临床表现，包括神经功能缺损和血管受压。虽然其潜在的病理生理学仍然复杂且具有多因素性，但已有报道称其与创伤、动静脉瘘形成和动脉粥样硬化存在潜在关联。
两名男性患者，年龄分别为33岁和38岁，有肾移植病史且既往有动静脉瘘（AVF），出现上肢缺血和神经功能受损症状。影像学检查发现巨大腋动脉瘤。两例均行开放手术修复。出院两周后，一名患者旋前和旋后功能良好，伸展功能轻度受限。另一名患者的垂腕经物理治疗后逐渐改善。
多因素病理生理学包括血流动力学改变、炎症和潜在的血管病变。主要症状和既往血管干预措施也有影响。与血管内治疗方法相比，开放手术修复更受青睐，并取得了良好的效果。
有动静脉瘘病史的患者发生腋动脉瘤虽罕见但可能是严重并发症。这些病例凸显了腋动脉瘤的复杂性以及仔细评估和手术干预的必要性。该策略对于预防潜在并发症和优化患者预后至关重要。需要进一步研究以阐明确切的病理生理学以及动静脉瘘与随后腋动脉瘤发生之间的潜在关联。提高外科医生的认识有助于更早发现动脉瘤，从而降低并发症风险。
