Traumatic radial artery pseudoaneurysm with cephalic venous graft repair

Abstract

A pseudoaneurysm of the radial artery is a rare vascular abnormality most frequently resulting from penetrating injuries or iatrogenic etiologies. The lack of structural integrity predisposes it to complications, including, but not limited to, rupture. In the given case, a middle-aged man presented with a pulsating mass over the flexor aspect of the right forearm secondary to a traumatic injury previously managed with debridement and suturing. Physical examination demonstrated a cystic swelling with a positive Nicoladoni-Branham sign. Doppler ultrasound findings were suggestive of an arteriovenous malformation. The lesion however was found to be a pseudoaneurysm intraoperatively. The patient underwent an exploratory surgery, including ligation and pseudoaneurysm excision, followed by reconstruction of the radial artery using a cephalic venous graft. Post operatively, the patient exhibited satisfactory healing with a healthy, patent graft. The increasing utilisation of the radial artery in procedures such as catheterisation owing to its accessibility, lower complication rates and faster recovery, establishes it as a key site for pseudoaneurysm formation. The absence of standardized diagnostic criteria complicates timely diagnosis and management of pseudoaneurysms, thereby increasing the risk of complications.