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We report a case of 66-year-old woman with true aneurysm of the right brachial artery. She presented with acute upper extremity ischemia. The hand was cold and parenthesized and distal pulses were absent. CT angiography (CTA) revealed a 20*25 mm true brachial artery aneurysm. The aneurysm was thrombosed without distal run-off. We excised the aneurysm and reestablished the arterial flow by a reverse saphenous interposition graft. The postoperative course was uneventful.

The aim of this paper is to describe the case of a patient successfully treated for left brachial arterial aneurysm occurring 15 years after renal transplantation and consequent 8 years after arteriovenous fistula (AVF) ligation. We describe our experience and our surgical approach. A 45-year-old man presented to our attention for a large pulsatile formation on the volatile face of the left forearm, which he reported to have enlarged in the last year. He had a history of chronic renal impairment in 2000, then AVF for dialysis was realized, and he was finally addressed to kidney transplantation in 2004. In 2011 the AVF was ligated. We observed absence of radial pulse and direct flow on the ulnar artery; a large pulsatile formation was evident along the course of the left brachial artery, associated with forearm venous dilatation. Doppler ultrasound showed fusiform aneurysm of the brachial artery with 3.5 cm diameter and longitudinal extension of 5 cm up to the brachial bifurcation. We removed the brachial aneurysm, with a venous bypass on the ulnar artery. The patient was discharged in good general condition on the second postoperative day. At 1- and 6-month follow-up he had complete recovery with graft patency, without any neurological impairment and with a good esthetic result. An open surgical repair with great saphenous vein interposition seems to be the best choice in terms of patency and perioperative morbidity.

Pediatric nonaortic arterial aneurysms are uncommon diagnoses and can be affiliated with underlying conditions, which include neurofibromatosis I, Ehlers-Danlos type IV syndrome, Kawasaki disease, Marfan syndrome, and Loeys-Dietz, polyarteritis nodosa, as well as Klippel-Trenauny syndrome. The standard of care has been early surgical excision and arterial reconstruction when indicated. This report details a case of recurrent brachial artery aneurysm in a 2-year-old boy despite multiple attempts at excision and reconstruction. Such recurrences were seen as rapidly as 3 months postoperatively. Ultimately, a Gore-Tex conduit was used to reinforce a reversed saphenous vein graft repair. There has been no evidence of recurrent disease during the 18-month follow-up period.

Introduction: Brachial artery aneurysm (BAA) is a rare late complication of arteriovenous fistula (AVF). It brings the risk of peripheral embolism and hand ischemia and is defined by brachial artery diameter above 10 mm or by regional dilatation by >50%. BAA is described in the literature in closed radiocephalic arteriovenous fistulas after kidney transplantation. The aim of the study was to analyze the prevalence of BAA and of their more dangerous forms. Method: A observational one center study performed on patients after kidney transplantation with AVF or arteriovenous graft (AVG). We invited all patients followed up for kidney transplantation in our center. Arterial diameter greater than 10 mm was considered as a brachial artery aneurysm to simplify the detection and evaluation of aneurysms. Results: About 162 patients with AVF after kidney transplantation were examined between 4/2018 and 4/2020. Brachial artery aneurysm was detected in 34 patients (21%) with AVF or AVG, of them 7 had confirmed wall thrombi. AVF flow volume of more than 1500 ml/min increased the risk of BAA development by 4.54x. Eight aneurysms were treated surgically. After this surgery, the primary patency was 87.5% in 12 months. Conclusion: Brachial artery aneurysm was relatively frequent in our study compare to the literature. Aneurysm or dilatation of the brachial artery is more frequent in functional AVFs. Surgical correction is necessary in cases of complicated aneurysms to prevent distal embolization.

Masson hemangioma is a rare benign vascular tumor characterized by intravascular papillary endothelial hyperplasia (IPEH). Numerous case reports have described lesions in the digits, neck, oral cavity, and intracranially. IPEH involving primary brachial artery aneurysm is extremely rare, with only a handful of reported cases. We present a 43-year-old female with a true distal brachial artery aneurysm who presented with a painful pulsatile mass in the antecubital region. She underwent aneurysm resection and end-to-end repair with a saphenous vein graft. Histology confirmed the diagnosis of IPEH with characteristic features of papillary hyperplasia within the intravascular thrombus.

Our patient exhibited a large tumor on his right upper arm where his former dialysis access site had been. X-ray, Doppler ultrasound, and magnetic resonance imaging scan could not fully reveal the nature of that tumor. Eventually, a surgical approach showed a giant aneurysm of the inflowing brachial artery to a partially obliterated arteriovenous fistula. This case highlights the importance of ongoing care for patients with arteriovenous shunts. Even arteriovenous fistulas, that are obliterated or no longer in use, can, especially when immunosuppressant therapy and other vascular risk factors are added to the overall cardiovascular risk, transform and endanger the health of our patients.

Introduction: Plasmablastic lymphoma is a rare and aggressive neoplasm, generally associated with immunodeficiencies and related to latent Epstein-Barr virus infection. This case is the first reported case of plasmablastic lymphoma relapse in aneurysmatic brachial artery wall. Case description: We describe the case of male patient who underwent cadaveric donor kidney transplant when he was 61 years old and radio-cephalic distal arteriovenous fistula ligation 8 months later. After 8 years, he developed gingival plasmablastic lymphoma treated with cyclophosphamide, hydroxydaunorubicin, oncovin and prednisone regimen with subsequent remission. During follow-up, a mid-forearm vascular access was created because of the worsening of renal function. Twenty-two months later, the patient showed a symptomatic 20 mm brachial artery aneurysm with radiological signs of imminent rupture, for which he was surgically treated. The histological evaluation of the brachial artery specimen revealed a relapse of plasmablastic lymphoma in the arterial wall and in an adjacent lymph node. Conclusion: Brachial artery aneurysms are a rare complication in kidney transplant recipients after ligation of arteriovenous access for haemodialysis. Here, we report a case in which this condition is associated with an even rarer plasmablastic lymphoma. A common aetiology, due to immunosuppressive therapy, is postulated for the two coexisting diseases.

Presented in the article is a clinical case report concerning successful surgical treatment of a rare disease - a progressing congenital true brachial artery aneurysm in a newborn girl. The symptoms were first noted at the age of 7 days, later on followed by enlargement of the aneurysm, appearance of neurological symptoms, and impaired function of the extremity. The infant was subjected to clinical examination and ultrasonographic study, followed by surgical removal of the aneurysm and restoration of the brachial artery by an 'end-to-end' anastomosis. The diagnosis was finally verified only at histological examination. Also contained in the article is a review of the literature underlining that paediatric arterial aneurysms are extremely uncommon, as well as discussing the problems of diagnosis and therapeutic policy. The dilatation of the vessel turned out to be a true aneurysm with all three layers of the vessel in the wall and belonged to the class of paediatric congenital idiopathic arterial aneurysms unassociated with degeneration of the vascular wall or cardiovascular pathology.В статье представлен случай успешного хирургического лечения редкого заболевания - прогрессирующей врожденной истинной аневризмы плечевой артерии у новорожденного ребенка. Симптомы впервые были отмечены в возрасте 7 дней. В дальнейшем было отмечено увеличение размеров аневризмы, появление неврологических симптомов, нарушение функции конечности. Обследование ребенка включало в себя клинический осмотр и ультразвуковое исследование. Выполнена операция удаления аневризмы с восстановлением плечевой артерии анастомозом 'конец в конец'. Окончательно диагноз был верифицирован только при гистологическом исследовании. Представлен обзор литературы, отражающий редкость патологии, проблемы диагностики и лечебной тактики. Расширение сосуда представляло собой истинную аневризму со всеми тремя слоями сосуда в стенке и относилась к классу детских врожденно-идиопатических артериальных аневризм вне связи с дегенерацией сосудистой стенки или сердечно-сосудистой патологией.

Introduction This case describes a brachial artery mycotic aneurysm (BAMA) secondary to infective endocarditis caused by Enterococcus faecalis. BAMAs are rare and potentially limb or life threatening. A literature review revealed 61 cases since 1950, primarily caused by intravenous drug use, with Staphylococcus aureus being the most common causative bacteria. Report A 71 year old man with known infective endocarditis presented with pulsatile swelling in his right antecubital fossa. A BAMA was confirmed on duplex scan. The patient underwent prompt extra-anatomic bypass with an ipsilateral cephalic vein graft. Discussion Bacterial endocarditis should be acknowledged as a cause of BAMA. Prompt diagnosis and intervention are essential., Highlights • Brachial artery mycotic aneurysm (BAMA) secondary to infective endocarditis. • Only case reported to be caused by haematogenous spread of Enterococcus faecalis. • BAMAs are rare and can be potentially limb or life threatening. • One must acknowledge bacterial endocarditis as a cause of BAMA. • Prompt diagnosis and intervention are essential for good outcomes.

Aneurysmal arterial dilatation is an infrequent complication following arteriovenous fistula ligation. Herein, we are describing a case in which a 49-year-old transplanted patient developed a true, symptomatic, brachial artery aneurysm 25 years after transplantation and 12 years after ligation of his radiocephalic wrist fistula. Treating strategy included aneurysmectomy and reversed vein interposition using ipsilateral, dilated branch of cephalic vein. Two years postoperatively, the patient remains without complications. Moreover, we mention the pathophysiologic mechanisms that may have contributed to this phenomenon.

Behçet’s disease is a vasculitic pathology characterized by skin lesions, genital ulcers, aphthous stomatitis, and uveitis. Arterial aneurysms are rare in this disease. Herein, we report a rare case of an isolated brachial artery aneurysm with a history of Behçet’s disease treated with endovascular covered stenting of the brachial artery.

Introduction The vascular pathology of patients with type 1 neurofibromatosis (NF-1) is known. Aneurysms of the brachial artery in NF-1 patients are rare and surgical treatment remains a challenge. Report A patient known to have NF-1 presented with swelling of the left arm. Computed tomography angiography showed a ruptured aneurysm of the brachial artery. Operative reconstruction was performed using reversed saphenous vein. Discussion Up to now four cases had been published describing brachial aneurysms in NF-1 patients. This case describes the successful reconstruction of a ruptured brachial aneurysm, using a saphenous vein., Highlights • Peripheral aneurysms in type 1 neurofibromatosis are rare. • Surgical reconstruction of a ruptured aneurysm of the brachial artery is challenging. • Successful reconstruction can be achieved with a saphenous vein bypass.

True peripheral artery aneurysms proximal to a longstanding arteriovenous fistula is a well-recognized complication. Late aneurysmal degeneration is rare. This study analyzed the characteristics, therapeutic options, and outcomes of true donor brachial artery aneurysms (DBAA) after arteriovenous fistula (AVF) for hemodialysis. We retrospectively collected the data of patients with DBAA after AVF creation, surgically repaired between January 2001 and September 2015. We excluded patients with pseudoaneurysms, anastomotic aneurysms, and infected aneurysms. We recorded patient's demographics, type of access, aneurysm characteristics, symptoms, treatment, and follow-up. Ten patients were treated for aneurysmal degeneration of the brachial artery. Average aneurysm diameter was 37.5 mm. All cases had, at least, one previous distal AVF, ligated or thrombosed, at the time of diagnosis. The first access was created in mean 137 months before the diagnosis of DBAA. Nine patients had previous medical history of renal transplant and were under immunosuppressive therapy. All patients were symptomatic at the time of diagnosis. In all cases, the treatment was aneurysmectomy followed by interposition bypass. One patient developed a postoperative hematoma with the need of surgical drainage. At 50 months of follow-up, one patient was submitted to percutaneous angioplasty due to an anastomotic stenosis. No other complications occurred during the entire follow-up period (mean: 69 months). The pathogenesis underlying DBAA remains unclear. Increased blood flow after AVF creation, immunosuppressive therapy, and ligation/thrombosis of the AVF may contribute to aneurysm formation. Surgical treatment by aneurysmectomy and bypass, with autogenous conducts, is a safe and effective option.

Introduction Peripheral artery aneurysms are a rare manifestation of Kawasaki disease (KD), with an estimated incidence of approximately 2% of all KD patients. The case of a 14-year-old girl with past clinical history suggestive of KD is reported; she presented with an aneurysm located in the brachial part of a superficial brachioulnoradial artery, still with the genuine brachial artery in place (an anatomical variation with a reported incidence of 0.14–1.3% in general population). Relevant medical data were collected from the hospital database. Report This is a report of a case of a symptomatic superficial brachioulnoradial artery aneurysm, secondary to KD, treated with aneurysm exclusion and superficial brachioulnoradial to the genuine brachial artery transposition. Uneventful intra- and postoperative course with symptom resolution is reported. Discussion The coexistence of a rare manifestation of KD (peripheral aneurysm) with an even rarer brachial artery variation allowed a simple but elegant solution, making this a unique case., Highlights • Peripheral artery aneurysms (PAA) in Kawasaki Disease (KD) are rare (2%). • Although life-threatening coronary involvement is of paramount importance, KD associated PAA may present as limb-threatening conditions. • The correlation between a PAA and KD vasculitis may be difficult to establish if the aneurysm is diagnosed years after the acute phase. • Variations in number and course of upper limb arteries have clinical and surgical importance, as demonstrated in this case.

Background A brachial artery aneurysm (BAA) is a rare condition accounting for 5% of all peripheral arterial aneurysms. More cases of true BAAs after arteriovenous fistula (AVF) closure have been reported in the past two decades. Case presentation A 60-year-old man who underwent AVF closure after renal transplantation had a true BAA on his left elbow that had grown within the past 6 months. We successfully performed an open repair with end-to-end anastomosis. No complications occurred for 1 year. Conclusions High flow due to AVF and some collateral factors such as the use of steroids and immunosuppressants after renal transplantation, arteriosclerosis, and chronic mechanical stimulation might contribute to BAA formation.

IntroductionL’artere brachiale est une artere rarement atteinte par la maladie anevrismale en comparaison aux autres territoires arteriels. Les vrais anevrismes sont exceptionnels et generalement asymptomatiques. Les formes symptomatiques se presentent sous la forme d’une masse pulsatile parfois douloureuse ou sous la forme d’une ischemie du membre superieur.

True arterial aneurysms of the upper extremity are rare. The case described is that of a 48-year-old man presenting with median neuropathy and distal vascular compromise 4 years after ligation of a brachiocephalic arteriovenous fistula. We describe our approach and present a review of the relevant literature.

ResumoNos doentes com insuficiência renal crónica terminal o aneurisma da artéria umeral proximal a uma fístula arterio-venosa (FAV) é uma complicação rara e tardia. Os objectivos do estudo foram a caracterização clínica e demográfica destes doentes, a análise da terapêutica cirúrgica adoptada e seus resultados.A análise foi observacional e retrospectiva, durante um período de 10 anos (2002-12) relativa aos doentes insuficientes renais crónicos com transplante renal e aneurisma umeral em membros com FAV rádio-cefálica prévia. Foram excluídos doentes com pseudo-aneurismas relacionados com acessos vasculares.Seis doentes, 5 homens (83%) e 1 mulher (17%) com a idade média de 54 anos, transplante renal e FAV rádio-cefálica laqueada/ocluída foram avaliados. A apresentação clínica mais comum foi a de massa umeral pulsátil indolor. O diâmetro médio dos aneurismas foi de 32,5mm. Todos os doentes foram submetidos a ressecção do aneurisma e interposição umero-umeral de conduto venoso em 4 doentes, protésico em 1 doente e a anastomose topo-a-topo em 1 doente. No follow-up médio de 35 meses verificou-se num doente trombose de enxerto protésico aos 2 meses e em 2 doentes degenerescência aneurismática (33%) do enxerto venoso e/ou artéria umeral proximal à reconstrução vascular aos 53 e 60 meses, o que motivou nos três doentes segunda intervenção cirúrgica. Não se registaram casos de perda de membro ou de mortalidade. Remodeling expansivo provocado pelo alto débito e shear stress proximal à FAV no contexto de maior sobrevida dos doentes com transplante renal em relação aos doentes em hemodiálise e o eventual efeito da terapêutica imunossupressora, poderão explicar a ocorrência deste efeito degenerativo. O conduto de eleição deve ser o enxerto venoso pela sua maior permeabilidade, não obstante o seu potencial de dilatação subsequente, pelo que é indispensável um programa de vigilância rigoroso.AbstractIn patients with end-stage chronic kidney disease, brachial artery aneurysms proximal to an arteriovenous fistula are a rare and late complication. The aim of this study was clinical and demographic characterization of these patients and analysis of the outcomes of surgical treatment.An observational retrospective study was conducted comprising a period of 10 years (2002-2012) on receivers of kidney transplant with brachial artery aneurysms in limbs with a previously constructed radiocephalic fistula. Patients with access-related pseudo-aneurysms were excluded.Six patients – 5 male (83%) and 1 female (17%) – with an average age of 54 years, all of whom were kidney transplant recipients and had a ligated/occluded radio-cephalic fistula. The most common presentation was a painless pulsatile mass. Average aneurysm diameter was 32.5mm. All patients had their aneurysm resected. An interposition graft was placed in 5 patients - vein graft in 4 patients, prosthetic graft in 1 patient. End-to-end anastomosis was performed in 1 patient. The average follow-up was 35 months, with thrombosis of 1 prosthetic graft at 2 months, 2 patients suffered aneurysmal degeneration (33%) of the graft and/or brachial artery proximal to the reconstruction at 53 and 60 months, all requiring a second procedure. No fatalities or cases of limb loss were recorded.Expansive remodeling caused by high flow and shear stress proximal to an arteriovenous fistula associated with longer survival of kidney transplant recipients and the effect of immunosuppressive therapy may explain development of these aneurysms. Our results point out that venous conduit should be the preferred choice by its longer patency, although requiring a non-invasive surveillance program by the risk of late aneurysmal degeneration.

Brachial artery (BA) aneurysms are rare, and most are false aneurysms. Although true BA aneurysms have been reported, most have been reported without symptoms. A 65-year-old man was referred due to a left upper limb mass with rest pain and slight ulceration of the left second and third fingers. As enhanced computed tomography revealed the patency of only the left proximal and distal BA as well as the thrombosed mass, excision of the aneurysm and BA replacement were performed with a great saphenous vein graft. The postoperative course was uneventful, and the rest pain and ulceration were resolved.

True aneurysm of the brachial artery is a rare disease entity. The mechanism of aneurysm formation is considered to be compression of the arterial wall, producing contusion of the media and subsequent weakness of the wall and fusiform dilatation. It can be caused by arteriosclerotic, congenital, and metabolic disorders, and can be associated with diseases such as Kawasaki's disease. Doppler ultrasonography, computed tomography, arteriography, and selective upper extremity angiography may be performed for establishing the diagnosis of aneurysm. The best therapeutic option is operative repair, and it should be performed without any delay, in order to prevent upper extremity ischemic or thrombotic sequelae. Here, we report a case of recurrent brachial artery aneurysm with review of the literature.

Upper extremity aneurysms are relatively infrequent when compared to other vessels in the body. However, a combination of factors occurring following arteriovenous fistula (AVF) ligation can lead to dilation of the brachial artery. Periodic follow-up after AVF creation can help prevent complications. We report a case of an immunosuppressed, patient with renal transplant who presented with delayed onset digital ischemia following ligation of a remotely created brachial artery-cephalic vein fistula.

An 83-year old man who had used bilateral axillary crutches for 67 years was referred to our hospital for acute left upper limb ischaemia. He underwent successful recanalization through emergent catheter thromboembolectomy. However, a crutch-induced left brachial artery aneurysm was subsequently detected by computed tomography. Therefore, we performed aneurysm exclusion and subsequent saphenous vein bypass grafting. When a crutch user presents with upper limb ischaemia, a high index of suspicion and early identification of the crutch induced vascular injury are mandatory for appropriate treatment.

Purpose Peripheral artery aneurysms proximal to a long-standing arteriovenous (AV) fistula can be a serious complication. It is important to be aware of this and manage it appropriately. Methods Vascular access nurses input all data regarding patients undergoing dialysis access procedures into a securely held database prospectively. This was retrospectively reviewed to identify cases of brachial artery aneurysms over the last 3 years. Results In Morriston Hospital, around 200 forearm and arm AV fistulas are performed annually for vascular access in renal dialysis patients. Of these, approximately 15 (7.5%) are ligated. Three patients who had developed brachial artery aneurysms following AV fistula ligation were identified. All 3 patients had developed brachial artery aneurysms following ligation of a long-standing brachio-cephalic AV fistula. Two patients presented with pain and a pulsatile mass in the arm, and one presented with pins and needles and discoloration of fingertips. Two were managed with resection of the aneurysm and reconstruction with a reversed long saphenous vein interposition graft, the third simply required ligation of a feeding arterial branch. Conclusions True aneurysm formation proximal to an AV fistula that has been ligated is a rare complication. There are several reasons for why these aneurysms develop in such patients, the most plausible one being the increase in blood flow and resistance following ligation of the AV fistula. Of note, all the patients in this study were on immunosuppressive therapy following successful renal transplantation. Vigilance by the vascular access team and nephrologists is paramount to identify those patients who may warrant further evaluation and investigation by the vascular surgeon.

While peripheral artery aneurysms are rarely encountered, brachial artery aneurysms are even rarer. Most of those seen are usually dissecting aneurysms of infectious, post-traumatic or iatrogenic origin; true aneurysms of the brachial artery are even more unusual.1 ,2 There may be a cause of in situ thrombosis, which might occlude vessels. The risk of limb loss can be avoided by prompt diagnosis and early surgery.3 ,4 The best therapeutic option is operative repair or closure by covered stent, although there are no uniform guidelines regarding the timing and indications of intervention. We present an interesting case of a 58-year-old man who presented with symptoms of atypical chest pain with non-specific ST-T changes in the ECG. The patient was taken up for a …

• Steal phenomenon through the vessel or rupture of brachial artery aneurysm could cause angina.

We report a case of true brachial artery aneurysm of idiopathic origin in a 53-year-old man complicated by distal thromboembolism resulting in acute critical upper limb ischemia. True aneurysm of the brachial artery is a very rare condition which may be asymptomatic or rarely present with acute thromboembolic episode. Surgical repair is the mainstay of treatment in these cases.

Brachial artery aneurysms and pseudoaneurysms are rare. What follows is a case of a pseudoaneurysm found in the right brachial artery in the mid upper arm. The patient denied trauma and there had not been any needle injections previously. The initial diagnosis was either a pseudoaneurysm or a saccular aneurysm. Surgical exploration suggested a spontaneous pseudoaneurysm.

True brachial artery aneurysms (BAAs) are uncommon peripheral vessel aneurysms that typically occur in the setting of injury. While its relationship with trauma and infectious etiologies are well defined, the association between arteriovenous fistulas (AVFs) and BAA is less well understood. We present a case of a giant true BAA that presented several years post-AVF ligation. A review of BAA, its association with AVF, and its management follows.

True aneurysms of the brachial artery are uncommon. We describe the presentation and surgical management of an isolated, brachial artery aneurysm in a 64-year-old woman. Excision of the aneurysm and long saphenous venous interposition grafting was performed with no postoperative complications and histology demonstrated true aneurysmal degeneration.

A patient with isolated right brachial artery aneurysms is presented. As a young woman these had been misdiagnosed, leading to inappropriate surgery and a subsequent brachial artery aneurysm produced median nerve neuropraxia. Resection of the aneurysm and bypass relieved these symptoms and the aetiology was fibromuscular dysplasia. The literature on fibromuscular dysplasia and aneurysms of the brachial artery are reviewed.

True brachial artery aneurysms remain extremely rare and are most commonly related to repetitive blunt trauma. Although operative repair of false aneurysms is well established, management of true aneurysms is varied due to their rarity. We present a true brachial artery aneurysm, in a 55-year old male, which occurred some 22-years following the repair of a posttraumatic false aneurysm. Following arterial duplex and computerised tomography, aneurysectomy with reversed interposition vein graft was performed.

Aneurysmal dilatation can occur infrequently at the proximal site of an arteriovenous fistula probably because of abnormal wall stresses. However, there might be other intrinsic factors that contribute to aneurysmal formation besides the fistula, because only a very small number of patients with fistulae develop such an aneurysm. We describe herein the histopathological characteristics of a brachial artery aneurysm in a 57-year-old male patient on cholesterol apheresis through a radio-cephalic fistula, and the relationship of the aneurysm with the underlying disease is discussed.

After the pioneer observations by Hunter more than two centuries ago, recent reports have expanded our knowledge about the occurrence and pathophysiology of arterial abnormalities associated with long-lasting hemodialysis arteriovenous fistula (AVF) after its closure. Observed abnormalities include arterial dilatation and aneurysm formation proximal to the site of the repaired AVF. We describe here a patient who developed, after long-lasting hemodialysis AVF, a pan-arterial dilatation with a large brachial artery aneurysm, which was successfully treated with a polytetrafluoroethylene bypass graft.

Elevated plasma homocysteine (Hcy) is one of the suggested risk factors for endothelial dysfunction. There is evidence of association between raised plasma Hcy and an increased risk of developing peripheral arterial disease. A causal relationship, however, has not been established. In this report, a 37-year old male patient with the complaints of intermittent hand pain is presented. Brachial artery aneurysm accompanying a homozygous methylenetetrahydrofolate reductase mutation was detected.

Mycotic aneurysms are extremely rare. Osler introduced the term in 1885 to describe an aortic aneurysm that resulted from bacterial endocarditis [1]. Since then the term has been given a broad definition to describe aneurysms, true or false of any artery, induced by infection of existing atherosclerotic aneurysm, traumatic injury, drug abuse or due to sepsis, local or embolic. A case of brachial artery mycotic aneurysm is presented which developed following a neglected perianal abscess. No similar case has been reported in available literature.

The development of pan-arterial dilatation proximal to longstanding traumatic arteriovenous fistulae (AVF) was first described by John Hunter over two centuries ago. 1 This is thought to be due to abnormal and hyperdynamic arterial flow patterns proximal to the AVF, which renders the proximal arteries particularly susceptible to atherosclerotic change and aneurysmal dilatation. 2–4 Aneurysmal arterial dilatation has been described infrequently as a late complication of traumatic AVF formation, 5,6 however, we describe a case in which acute on chronic late brachial artery aneurysmal dilatation occurred following previous Brescia-Cimino AVF formation, which had been ligated several years earlier after renal transplantation.

An arterial aneurysm of any kind is rare in infancy, and one that occurs in the brachial artery is probably even more rare; when such an aneurysm is asymptomatic and congenital, it must be exceedingly rare. One such unique case is described herein, together with a brief review of the literature.

Fibromuscular dysplasia is a pathologic process causing stenosis and dilation of medium-caliber arteries of unknown etiology. It most commonly affects the renal and carotid arteries; however, it has been described in virtually all anatomic areas, including, rarely, the brachial artery. We describe a case of brachial artery aneurysm and thrombosis in a 29-year-old man secondary to fibromuscular dysplasia, treated surgically with excision, embolectomy, interposed vein graft, and anticoagulation.

Accidental arterial injury at time of blood donation is rare, but may lead to localized thrombosis and hematoma formation, and rarely, development of pseudo-aneurysm. We report the first case of true brachial artery aneurysm formation as complication of arterial injury from blood donation.