Confronting a Vascular Giant: A Case Report and Review of a Postoperative Brachial Artery Pseudoaneurysm

Abstract

Background: A pseudoaneurysm (PSA) is a focal arterial dilation caused by blood leakage from a vessel, forming a localized hematoma enclosed by a fibrin wall. Unlike true aneurysms, PSAs lack involvement of all vessel wall layers. Rare in peripheral arteries, they cause life-threatening complications if untreated.
Case Report: We report a case of a 42-year-old male who developed a left brachial artery PSA following surgical removal of a titanium elastic nail. The patient presented with a 6-month history of a pulsatile swelling. Imaging revealed a fusiform PSA with partial thrombotic occlusion. Surgical excision was performed, and the brachial artery reconstructed with a great saphenous vein interposition graft.
Conclusions: Brachial artery PSAs are uncommon and result from trauma or surgical intervention. Treatment involves open surgical repair with vein grafting. Alternative approaches, including endovascular stent grafting and coil embolization, may be viable. Early diagnosis and tailored management are essential to prevent complications.