Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492008005000001
Jornal Vascular Brasileiro
Case Report

Aneurisma idiopático da artéria radial na região da tabaqueira anatômica: relato de caso

Idiopathic radial aneurysm in the anatomical snuffbox: case report

Aline Cristine Barbosa Santos; Fabrício Mascarenhas de Oliveira; José Guilherme de Oliveira; Edgard Bolanho; Tasso Roberti; Ulisses Ubaldo Matosinho Mathias; Regina de Faria Bittencourt da Costa; Nelson Fernandes Júnior

Downloads: 0
Views: 950

Resumo

Paciente do sexo feminino, 73 anos, negra, lavadeira/lavradora, hipertensa, apresentava tumor pulsátil de 1,5 x 0,5 cm em região de tabaqueira anatômica da mão direita há 10 anos, de crescimento lento e progressivo, associado a dor local. Não apresentava alterações neurológicas, cianose de extremidades, sinais de infecção ou trauma local. O teste de Allen resultou negativo, e o Eco-Doppler colorido demonstrou aneurisma de artéria radial na tabaqueira anatômica. Procedeu-se a aneurismectomia de artéria radial na tabaqueira anatômica com ligadura dupla proximal e distal. Houve boa evolução operatória, sem sinais de isquemia digital. O exame anatomopatológico confirmou diagnóstico de parede arterial (aneurisma verdadeiro). O paciente encontra-se em acompanhamento ambulatorial, no momento assintomático. Não há definição de quais aneurismas distais à artéria axilar possam ser acompanhados sem conduta cirúrgica. Como a paciente, neste caso, apresentava teste de Allen normal e dor local, optou-se pela ligadura proximal e distal, com bom resultado.

Palavras-chave

Aneurisma, idiopático, artéria radial, mão

Abstract

We report a case of a 73-year-old female, laundress/farmer, hypertensive, with symptomatic pulsatile lump of 1.5 x 0.5 cm at the right anatomical snuffbox of the right hand, with slow and progressive growth and local pain in the past 10 years. The patient presented no neurological symptoms, cyanosis, infection or local trauma history. Allen"s test was negative, and color Doppler ultrasound confirmed presence of radial artery aneurysm in the anatomical snuffbox. Surgical treatment via aneurysmectomy of radial artery in the snuffbox with proximal and distal ligation was carried out. She had good operative course with no signs of digital ischemia. Histopathological test confirmed diagnosis of arterial wall (true aneurysm). She remains asymptomatic in outpatient follow-up. There is no definition as to which aneurysms distal to the axillary artery could be followed without a surgical procedure. As the patients had normal Allen"s test and local pain, proximal and distal ligation was chosen and had good outcome.

Keywords

Aneurysm, idiopathic, radial artery, hand

References

Brito CJ. Aneurismas arteriais periféricos. Doenças vasculares periféricas. 2002:1149-67.

Brito CJ, Azevedo Jr. AC, Schulze GC. Aneurismas periféricos. Cirurgia vascular. 2002:534-50.

Behar JM, Winston JS, Knowles J, Myint F. Radial artery aneurysm resulting from repetitive occupational injury: Tailor"s thumb. Eur J Vasc Endovasc Surg. 2007;34:299-301.

Yaghoubian A, de Virgilio C. Noniatrogenic aneurysm of the distal radial artery: a case report. Ann Vasc Surg. 2006;20:784-6.

Walton NP, Choudhary F. Idiopathic radial artery aneurysm in the anatomical snuff box. Acta Orthop Belg. 2002;68:292-4.

Gray RJ, Stone WM, Fowl RJ, Cherry KJ, Bower TC. Management of true aneurysms distal to the axillary artery. J Vasc Surg. 1998;28:606-10.

Ruengsakulrach P, Brooks M, Hare DL, Gordon I, Buxton BF. Preoperative assessment of hand circulation by means of Doppler ultrasonography and the modified Allen test. J Thorac Cardiovasc Surg. 2001;121:526-31.

Al-Omran M. True ulnar artery aneurysm of the hand in an 18-month-old boy: a case report. J Vasc Surg. 2007;45:841-3.

Hattori N, Furuta Y, Shiraishi K, Nakayama T, Isobe K, Tanaka T. The radial artery aneurysm within the anatomical snuffbox. Jpn J Vasc Surg. 2004;13:597-601.

Miura S, Kigawa I, Miyari T, Fukuda S. A surgically treated case of true radial arterial aneurysm in the anatomical snuffbox. Jpn J Vasc Surg. 2004;13:687-690.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5ddd485c0e882504531da3e9 jvb Articles
Links & Downloads

J Vasc Bras

Share this page
Page Sections