Axillary artery aneurysms

Aneurysms of the axillary artery are rare but potentially dangerous lesions that threaten the upper extremity with vascular and neurologic compromise. Most can be treated effectively with surgical excision and vascular grafting. An illustrative case is presented. These aneurysms may arise as pseudoaneurysms secondary to trauma or iatrogenic complications, or as degenerative lesions often secondary to the chronic use of crutches. They may also arise as postobstructive lesions in patients with thoracic outlet syndrome. Signs and symptoms vary with the cause of the aneurysm and may include mass effects with brachial plexus compression and thromboembolic events involving the hands and fingers. Arteriography is the mainstay of diagnosis, and treatment should be considered in most of these lesions as soon as they become apparent to prevent limb loss or dysfunction.