Abstract
True brachial artery aneurysms in children are mostly uncommon. When present, they are often associated with connective tissue disorders or arteritis. We report a case of brachial artery aneurysm, which initially being misdiagnosed as swollen lymphnode. The patient was born at 39 weeks gestation to a healthy. At 2 years 9 months of age, she had a soft increasing pulsatile mass measuring 2 × 8 cm at the medial aspect of the right upper arm by US scanning. Angiography of the right upper arm mass revealed 2 fusiform aneurysms arising from the proximal right brachial artery, as well as very severe stenosis of the left brachial artery with much collateral circulation to the distal arm. The right brachial artery aneurysm was excised and reconstructed by a saphenous vein graft. Histological examination of the excised specimen showed edematous change in intima and fragmented elastin fiber, but disclosed no specific findings of Takayasu’s arteritis. The choice of arterial conduit is especially problematic these children. We have successfully reconstructed with a saphenous vein graft due to good patency, flexibility and durability to tortuous forces. The patient recovered uneventfully with normal wound healing during 1 week observation before discharge. To our knowledge, this is the youngest case in Japan, which was reconstructed brachial artery for the aneurysm. Because Takayasu’s arteitis is strongly suspected according to the guideline of Takayasu’s arteritis in children, careful follow-up is must be required.
