Successful Endovascular Repair of a Rare Delayed Axillary Artery Pseudoaneurysm after Humeral Fracture

Abstract

Axillary artery pseudoaneurysms following proximal humeral fractures are rare, particularly in elderly patients after
low-energy trauma, and may present in a delayed manner, posing diagnostic challenges. We report a 76-year-old woman with a displaced proximal humeral fracture who returned four days later with severe anemia and extensive shoulder ecchymosis. Computed tomography angiography revealed a 35 × 20 mm axillary artery pseudoaneurysm within a large hematoma. The lesion was successfully excluded using a covered endovascular stent via femoral access, with post-procedure imaging confirming patency and complete pseudoaneurysm exclusion. The patient recovered uneventfully and was discharged two days later. This case highlights the need for high clinical vigilance in elderly patients and demonstrates that endovascular repair provides a safe, minimally invasive, and effective alternative to open surgery, expanding therapeutic options for combined orthopedic and vascular trauma.