A 65-year-old man presented with a pulsatile mass in the left forearm, of several years of evolution, and with a rapid and progressive growth, from Nephrology to Vascular Surgery.
Personal history of arterial hypertension, dyslipidemia, radiocefic fistula previously left for hemodialysis performed twenty years due to terminal chronic renal failure, and six years after it was ligated.
On physical examination, the anterior aspect of the left forearm showed an enormous pulsatile tumor, with no murmur or thrill.
The patient was well perfused with radial and ulnar pulses.
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Firstly, an echodoppler was performed, which showed intense flow inside the tumor. It was not possible to define whether it was an aneurysm or a pseudoaneurysm of the radial artery or permelanoma.
With the diagnostic suspicion of aneurysm or pseudoaneurysm of the radial artery secondary to AVF radioceffix ligated in a patient, surgical treatment was indicated.
Median incisions at arm flexure level and distally at radial level, we proceeded to dissection and control of radial and ulnar humid artery, appreciating a large true radial artery throughout the trajectory.
Complete resection of the aneurysm was performed, connecting the radial artery to the proximal and distal level, since it was proven that it was chronically thrombosed and the vascularisation of the hand was ensured by the ulnar and interosseous arteries.
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The postoperative course was uneventful; at discharge the patient presented humble and cubital pulses and good hand perfusion.
Pathology confirmed that it was a true aneurysm of the radial artery.
One year after treatment, the patient is asymptomatic and without complications.
