PMC4801088_01
Computed tomography angiogram (A) demonstrating the presence of a multilocular ulnar artery aneurysm, a persistent median artery, and absence of the palmar arterial arch system. Under tourniquet, the aneurysm was approached with a direct incision, exposing the entirety of the lesion from the mid-forearm proximally to the mid-palm distally (B). After resection of the lesion, the ulnar artery was reconstructed with a reversed cephalic vein graft harvested from the ipsilateral forearm (C).
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F1
Computed tomography angiography demonstrated a 2.3 x 1.5 cm ulnar artery aneurysm at the volar surface of the ulnar-carpal junction, a second 0.5 cm aneurysm just proximal to the hook of the hamate, and a third 1.5 x 1.2 cm aneurysm in the palm (Fig. 1). An incision was made along the volar aspect of the wrist and palm over the pulsatile lesion, and the aneurysm exposed and excised, with care taken to identify and preserve the adjacent ulnar nerve (Fig. 1). The cephalic vein of the ipsilateral forearm was harvested and used as a reversed interposition graft for reconstruction of the artery (Fig. 1).