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Angiologiia I Sosudistaia Khirurgiia =... 2020Presented in the article is a clinical case report concerning successful surgical treatment of a rare disease - a progressing congenital true brachial artery aneurysm in... (Review)
Review
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.
Topics: Anastomosis, Surgical; Aneurysm; Brachial Artery; Child; Female; Humans; Infant; Infant, Newborn
PubMed: 32240152
DOI: 10.33529/ANGIO2020105 -
Techniques in Vascular and... Jun 2015Low brachial artery access is a safe alternative approach for the interventionalist when the femoral artery approach is not feasible or desirable. One important...
Low brachial artery access is a safe alternative approach for the interventionalist when the femoral artery approach is not feasible or desirable. One important advantage of upper extremity access is the favorable route of entry from above into the caudally oriented visceral arteries. Although the risk of complications is low for experienced operators, meticulous attention to technique and knowledge of local anatomy are imperative to safely use brachial artery access. Adequate anticoagulation with heparin and use of lowest-profile devices may minimize complications. Following these procedures, patients must be carefully evaluated immediately and trained to self-monitor for up to 2 weeks for signs and symptoms of bleeding and nerve compression. This article describes the indications, procedural steps, expected outcomes, and tips on overcoming technical challenges of brachial artery access.
Topics: Brachial Artery; Endovascular Procedures; Humans; Radiography, Interventional; Vascular Access Devices
PubMed: 26070620
DOI: 10.1053/j.tvir.2015.04.006 -
Cardiovascular Revascularization... Oct 2020
Topics: Brachial Artery; Catheterization, Peripheral; Humans; Punctures; Retrospective Studies
PubMed: 32792220
DOI: 10.1016/j.carrev.2020.07.020 -
European Journal of Vascular and... Jan 2024
Topics: Humans; Brachial Artery; Aneurysm; Arteriovenous Shunt, Surgical
PubMed: 37827239
DOI: 10.1016/j.ejvs.2023.10.002 -
Journal de Medecine Vasculaire Sep 2023
Topics: Humans; Brachial Artery; Vascular Surgical Procedures; Wounds, Penetrating
PubMed: 37914459
DOI: 10.1016/j.jdmv.2023.08.001 -
Advances in Physiology Education Sep 2022There is extensive and increasing use of ultrasound in medical care and scientific research, so it is important that the technique, indication, and interpretation of...
There is extensive and increasing use of ultrasound in medical care and scientific research, so it is important that the technique, indication, and interpretation of ultrasound investigations are included in medical and biological education. Applications of ultrasound in medical care and education employ not only noninvasive imaging of structure but also the evaluation of organ function. Vascular ultrasound is one such application that has been hitherto relatively neglected in physiology education. The techniques of vascular ultrasound and the physiological regulation of human limb blood flow are reviewed to inform students and curriculum designers. Emphasis is placed on the value of converting velocity measurement by ultrasound to volumetric flow and on the mechanisms involved in rapidly changing flows with interventions. Live collection of real data by ultrasound can show macrovascular and microvascular features of vascular physiology. Macrovascular features include imaging and flow velocity profiles. Microvascular perfusion studies show conductance changes with interventions such as exercise and ischemia. Vascular ultrasound offers exciting opportunities for undergraduate research projects using human subjects. The literature is interesting and, though complex, offers excellent educational experience, with scope for the development of critical thinking and meaningful original research. Ultrasound imaging has emergent prominence in clinical investigation and education. Vascular ultrasound also evaluates function. Simple methods are described that enable the application of basic ultrasound principles to the measurement of velocity and, importantly, to calculate absolute volumetric blood flow. These methods should be useful in undergraduate and graduate education, with application in clinical practice and research.
Topics: Blood Flow Velocity; Brachial Artery; Humans; Ultrasonography
PubMed: 35796466
DOI: 10.1152/advan.00157.2021 -
BMJ Case Reports May 2014We describe a case of an elderly man who presented with an upper arm swelling that had developed following a humeral fracture 8 months previously. The swelling was...
We describe a case of an elderly man who presented with an upper arm swelling that had developed following a humeral fracture 8 months previously. The swelling was painless but associated with significantly diminished motor function of his right hand and concurrent paraesthaesia. On examination, a large pulsatile mass was identified and CT angiography confirmed the presence of an 11×7 cm brachial artery pseudoaneurysm. The patient underwent surgical repair in which a fragment of the humerus was found to have punctured the brachial artery resulting in a pseudoaneurysm. The patient had an uncomplicated postoperative period and was discharged 2 days later having regained some motor function in his right hand.
Topics: Aged, 80 and over; Aneurysm, False; Angiography; Brachial Artery; Humans; Humeral Fractures; Humerus; Male
PubMed: 24859555
DOI: 10.1136/bcr-2014-203924 -
South African Journal of Surgery.... Mar 2022The start of the armed conflicts in Libyan society in 2011 led to a dramatic increase in the incidences of unusual types of brachial artery injuries, which were...
BACKGROUND
The start of the armed conflicts in Libyan society in 2011 led to a dramatic increase in the incidences of unusual types of brachial artery injuries, which were previously uncommon. In this study, the postoperative outcomes have been compared prospectively between patients who have had injuries at the proximal anatomical half of the brachial artery with those who suffered injuries at the distal anatomical half.
METHODS
A cohort study was undertaken to compare patients who had an injury at the proximal anatomical half of the brachial artery (considered as the first group) and patients who had an injury at the distal anatomical half of the brachial artery (considered as the second group). This was undertaken to analyse the influence of the anatomical site of injury on the postoperative outcomes in patients who underwent urgent surgical repair procedures at the hospital from February 2011 to December 2016.
RESULTS
Out of fifty-one patients, 31 (60.8%) patients had gunshot injuries, 12 (23.5%) had explosive injuries, four (7.8%) had stab wounds and four (7.8%) were victims of road traffic accidents. There were 13 (25.5%) patients in the first group and 38 (74.5%) patients in the second group. Three patients (5.9%) had postoperative arterial occlusion due to thrombosis, while two (3.9%) had postoperative graft occlusion due to thrombosis; the other two (3.9%) had compartment syndrome.
CONCLUSION
Based on the anatomical background, critical limb ischaemia and postoperative ischaemic complications, as well as delayed limb amputation, are more associated with the injuries to the proximal anatomical half of the brachial artery due to poor collateral circulation at this level.
Topics: Amputation, Surgical; Brachial Artery; Cohort Studies; Humans; Retrospective Studies; Upper Extremity; Wounds, Stab
PubMed: 35451270
DOI: No ID Found -
The American Surgeon Aug 2022A 6-month-old male was admitted to the children's hospital for management of an underlying gastrointestinal illness. During his admission, a large, pulsatile mass was...
A 6-month-old male was admitted to the children's hospital for management of an underlying gastrointestinal illness. During his admission, a large, pulsatile mass was incidentally noted in the left upper arm concerning for an expanding pseudoaneurysm. Vascular surgery was consulted, and further workup with a CT angiogram demonstrated a brachial artery aneurysm 3 cm in greatest diameter. The patient was taken to the operating room, where lateral aneurysmorraphy was performed without complication. His neurovascular exam remained intact postoperatively. The presented case demonstrates a viable approach to the surgical management of this clinical challenge in infants. Although reports of brachial artery aneurysm in this age group are rare in the literature, resection with primary repair and interposition grafting have also been described. Long-term outcomes are not available in these cases. Lateral aneurysmorraphy allows for ongoing monitoring and future resection and bypass of the aneurysm as the patient continues to grow.
Topics: Aneurysm; Aneurysm, False; Brachial Artery; Child; Humans; Infant; Male; Treatment Outcome; Vascular Surgical Procedures
PubMed: 35484636
DOI: 10.1177/00031348221087903 -
Journal of Vascular and Interventional... Apr 2023To estimate the rates of technical success and adverse events of vascular closure devices (VCDs) in the brachial artery and compare the rates of adverse events with... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To estimate the rates of technical success and adverse events of vascular closure devices (VCDs) in the brachial artery and compare the rates of adverse events with manual compression.
MATERIALS AND METHODS
MEDLINE and Embase were searched for observational studies examining VCDs in the brachial artery. Meta-analyses were performed using random effects for the following outcomes: (a) technical success, (b) hematoma at the access site, (c) pseudoaneurysm, (d) local neurological adverse events, and (e) total number of adverse events. A pairwise meta-analysis compared VCD with manual compression for the outcomes of hematoma and the total number of adverse events.
RESULTS
Of 1,761 eligible records, 16 studies including 510 access sites were included. Primary procedures performed were peripheral arterial disease interventions, percutaneous coronary intervention, and endovascular thrombectomy for ischemic stroke. The technical success rate was 93% (95% CI, 87%-96%; I = 47%). Data on the following adverse events were obtained via meta-analysis: (a) hematoma, 9% (5%-15%; I = 54%); (b) stenosis or occlusion at access site, 3% (1%-14%; I = 51%); (c) infection, 0% (0%-5%; I = 0%); (d) pseudoaneurysm, 4% (1%-13%; I = 61%); (e) local neurological adverse events, 5% (2%-13%; I = 54%); and (f) total number of adverse events, 15% (10%-22%; I = 51%). Angio-Seal success rate was 96% (93%-98%; I = 0%), whereas the ExoSeal success rate was 93% (69%-99%; I = 61%). When comparing VCD and manual compression, there was no difference in hematoma formation (relative risk, 0.75; 95% CI, 0.35-1.63; I = 0%; P = .47) or the total number of adverse events (relative risk, 0.75; 95% CI, 0.35-1.58; I = 76%; P = .45).
CONCLUSIONS
Despite being off-label, studies suggest that VCDs in the brachial artery have a high technical success rate. There was no significant difference in adverse events between VCDs and manual compression in the brachial artery.
Topics: Humans; Vascular Closure Devices; Brachial Artery; Aneurysm, False; Femoral Artery; Hematoma; Treatment Outcome; Hemostatic Techniques
PubMed: 36526077
DOI: 10.1016/j.jvir.2022.12.022