Surgical experience of post-traumatic pseudo aneurysm of the brachial artery at a tertiary care hospital.

OBJECTIVE To determine the frequency of peripheral artery aneurysms in the upper extremities. METHODS A descriptive study of acute vascular injury patients presenting to the emergency department of Civil Sandmen Teaching Hospital Quetta, from August 1995 to July 2003, was undertaken. We performed aneurysmal resection together with saphenous vein graft interposition in 7 patients with a diagnosis of post-traumatic brachial pseudo aneurysm. RESULTS Three patients had gunshot wounds (44%), 3 (42.8%) stab wounds and one patient (14.2%) had blunt trauma. The mean duration from injury to hospital admission was 26.7 months (range 17 months-7 years). All patients underwent color-flow arterial Doppler ultrasonography and aneurysmal resection and saphenous vein graft interposition. There was no instance of death or ischaemic extremity loss. Patients were discharged from the hospital a mean of 3.2 days after surgery (range 2-6 days). Early and late graft patency rates were 100%. We followed the patients' cases for a mean of 3.4 years (range 1 month-7 years). CONCLUSION Very rarely, post-traumatic upper extremity pseudo aneurysms show symptoms after a long period of time. Diagnosis was very easy with a review of the patient's history and a physical examination. Surgical reconstruction is the preferred treatment for such cases.