Co esponding au ho : S. A. AHMED AMAR
Copy igh © 2025 Au ho (s) e ain he copy igh o his a icle. This a icle is published unde he e ms o he C ea i e Commons A ibu ion License 4.0.
Bila e al Axilla y A e y Aneu ysms: A case epo
Sidi. Abdallah. AHMED AMAR *, Hemza. Dabachi, Sami . El Youbi, Hemza. Naouli, Hami . Jibe and Abdella i .
Boua h oum
Vascula Su ge y Depa men , Hassan II Uni e si y Hospi al, Fes Facul y o Medicine, Pha macy, and Den is y, Uni e si y
o Fes, Mo occo.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 647-651
Publica ion his o y: Recei ed on 30 June 2025; e ised on 09 Augus 2025; accep ed on 11 Augus 2025
A icle DOI: h ps://doi.o g/10.30574/wja .2025.27.2.2899
Abs ac
An aneu ysm is de ined as a loss o a e ial pa allelism associa ed wi h an inc ease in essel diame e exceeding 50%
o he o iginal size. Axilla y a e y aneu ysms a e a e and o en asymp oma ic. Thei clinical p esen a ion includes
pain ul pulsa ile masses, uppe limb ischemia, o up u e. We p esen a case o bila e al axilla y a e y aneu ysms o
highligh he managemen o his a e condi ion, whe e su gical in e en ion emains he co ne s one, wi h
endo ascula app oaches playing a suppo i e ole.
Keywo ds: Aneu ysm; Axilla y A e y; Ischemia; Pain ul Mass; P os he ic Bypass
1. In oduc ion
Axilla y a e y aneu ysms a e a a e o m o pe iphe al a e ial aneu ysms. They can mani es as pulsa ile axilla y
masses, comp ession- ela ed neu algia, o complica ions such as dis al emboliza ion o up u e(1). We epo he case
o a 61-yea -old woman wi h end-s age enal disease on ch onic hemodialysis ia a adiocephalic a e io enous is ula
(AVF), who p esen ed wi h bila e al axilla y a e y aneu ysms. The diagnosis was clinically e iden and con i med by
CT angiog aphy. The mos p obable e iology was in ec ious, and he pa ien was ea ed su gically ia aneu ysm
esec ion and axillo-axilla y bypass.
2. Case P esen a ion
M s. X, a 61-yea -old woman wi h end-s age ch onic kidney disease on hemodialysis h ough a le adiocephalic AVF,
p esen ed wi h bila e al pulsa ile axilla y masses e ol ing o e i e yea s. The clinical wo sening included inc eased
olume and pain in he le axilla y egion, wi hou ischemia o up u e ( igu e 1)
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 647-651
648
Figu e 1 Clinical aspec
On examina ion, he e we e wo pulsa ile masses in bo h axillae (Figu e 1). Pe iphe al pulses we e p ese ed.
Hemoglobin was 6 g/dL, wi h leukopenia (2,000/mm³) and h ombocy openia (75,000/mm³). CT angiog aphy e ealed
ue aneu ysms o bo h axilla y a e ies, measu ing 10 cm (le ) and 5 cm ( igh ), pa ially h ombosed, wi hou signs
o up u e o ho acic ou le synd ome (Figu e 2).
Figu e 2 Bila e al axilla y aneu ysm, wi h he la ges on he le measu ing 10 cm in diame e
A e ans usion wi h h ee uni s o packed ed cells and pla ele s, he pa ien unde wen su ge y. The le axilla y
aneu ysm was esec ed, and an axillo-axilla y bypass was pe o med using a ein o ced PTFE p os hesis (Figu es 3–6).
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 647-651
649
Figu e 3 The axilla y subcla ian junc ion dissec ion and con ol
Figu e 4 Axilla y a e y con ol
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 647-651
650
Figu e 5 P oximal and dis al con ol o he aneu ysm wi h iden i ica ion and con ol o b achial plexus b anches
Figu e 6 Aneu ysm esec ion ollowed by axillo-axilla y bypass using PTFE g a
Pos ope a i ely, he limb was wa m and all pulses we e p esen . Bac e iological cul u es we e nega i e, and
his opa hology a o ed an a he oscle o ic o igin.
3. Discussion
Axilla y a e y aneu ysms a e he a es among pe iphe al a e ial aneu ysms. A he oscle osis is a common cause,
al hough connec i e issue diso de s, ho acic ou le synd ome, and epe i i e auma a e also implica ed (2).
Clinical p esen a ion can a y om pulsa ile o pain ul masses o ischemia o neu ologic symp oms due o ne e
comp ession. Dopple ul asound can aid diagnosis bu may misin e p e pseudoaneu ysms. CT angiog aphy emains
he gold s anda d, bo h o diagnosis and ea men planning (4)
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 647-651
651
T ea men in ol es exclusion o he aneu ysm and decomp ession(3) (4). Su gical esec ion wi h e ascula iza ion ia
au ologous ein g a o p os he ic condui is he s anda d. Endo ascula epai using co e ed s en s is a iable op ion,
especially in high- isk su gical candida es. Howe e , in cases wi h la ge aneu ysms and comp essi e symp oms, open
su ge y is p e e ed as endo ascula app oaches may no elie e mass e ec . (5,6)
Pos ope a i e complica ions may include pa es hesia due o he close p oximi y o he b achial plexus. In ou case,
neu ological examina ion was no mal a e su ge y. (7)
4. Conclusion
Axilla y a e y aneu ysms a e a e bu po en ially li e- and limb- h ea ening. They may lead o ascula o neu ologic
comp ession, h omboembolic e en s, o up u e. Su ge y emains he p ima y ea men , wi h endo ascula op ions
conside ed in selec ed cases.
Compliance wi h e hical s anda ds
Disclosu e o con lic o in e es
No con lic o in e es o be disclosed.
S a emen o in o med consen
In o med consen was ob ained om all indi idual pa icipan s included in he s udy.
Re e ences
[1] Mu ie JA. A e ial diso de s. In: Bailey and Lo e’s Sho P ac ice o Su ge y. 25 h ed. London: Edwa d A nold;
2008: 899–923.
[2] Gup a S, e al. Axilla y a e y aneu ysm. J Eme g Med. 2005;28:215–6.
[3] G ay R, e al. Managemen o ue aneu ysms dis al o he axilla y a e y. J Vasc Su g. 1998;28:606–10.
[4] Malik M, e al. Spon aneous axilla y a e y aneu ysm: a case epo and li e a u e e iew. Vascula . 2012;20:46–
8.
[5] Schneide K, e al. Axilla y a e y aneu ysm in a baseball pi che : case epo . Am J Spo s Med. 1999;27:370–5.
[6] He C, e al. Endo ascula managemen o spon aneous axilla y aneu ysm. J Med Case Rep. 2013;7:140.
[7] Jhi ad R, Kalman PG. Myco ic axilla y aneu ysm. J Vasc Su g. 1998;28:708–9.
