Radial Artery Aneurysm Requiring Reconstruction Following Previous Ulnar Artery Ligation: A Case Report Motaz Joma Hamad

Abstract

Radial artery aneurysms are uncommon, and management is particularly challe,nging when alternative arterial perfusion of the hand is inadequate. A 70-year-old woman presented with a three-month history of a slowly enlarging pulsatile swelling in the right anatomical snuffbox. Ten years earlier, she had sustained a laceration of the same wrist requiring ulnar artery ligation. Examination demonstrated a 1.5 × 1.2 cm pulsatile mass with a warm, well-perfused hand. Duplex ultrasonography demonstrated an 8-mm saccular distal radial artery aneurysm without intraluminal thrombus and no detectable ulnar arterial flow. Allen testing was abnormal, with delayed reperfusion of >10 seconds. Because radial artery sacrifice could not be assumed to be safe, the aneurysm was excised and arterial continuity restored by primary end-to-end anastomosis. Recovery was uncomplicated. At three months, duplex ultrasonography demonstrated a patent anastomosis with normal flow, and the patient had full hand function without ischaemic symptoms. This case highlights the importance of assessing hand perfusion before treatment of radial artery aneurysms and supports preservation of arterial continuity when alternative arterial inflow is inadequate.