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      Aneurysm of Upper Limb Arteries in Children: Report of Five Cases

      case-report
      1 , 2 , , 2 , 3
      Case Reports in Medicine
      Hindawi

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          Abstract

          Background

          Arterial aneurysm in children is rare.

          Aim

          To present the description of case series of successful surgical treatment of upper limb aneurysms in children. The case series included 2 boys and 3 girls, with median age 3.3 years. One of them was a newborn with a true brachial artery aneurysm. Aneurysms were in the brachial ( n = 3) and radial ( n = 2) arteries. Two patients had idiopathic aneurysms. Two cases were associated with connective tissue dysplasia syndrome. One patient had a history of trauma. In 4 of 5 cases, there was a true aneurysm and in one a pseudoaneurysm. Diagnosis was carried out in all cases by using ultrasound, with arteriography in one case. All 5 children were operated on. Resection of the aneurysm and restoration of arterial patency was performed in 4 of 5 cases (ligation of the radial artery near the aneurysm in 1 case, aneurysm resection with end-to-end anastomosis in 1 case, resection with PTFE graft implantation in 1 case, and resection with implantation of an autovenous graft in 2 cases. Complications. Dysfunction and thrombosis of the PTFE graft required reoperation using an autovenous graft.

          Conclusion

          Despite the rarity of the disease, timely and adequate surgical treatment of aneurysms of the arteries of the upper extremities in children is possible successfully in a specialized hospital.

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          Most cited references12

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          Arterial aneurysms in children: clinicopathologic classification.

          Thirty-one arterial macroaneurysms in 23 pediatric-aged patients (16 boys and 7 girls) were treated at the University of Michigan. The average age at time of diagnosis was 10.2 years (range 6 months to 18 years). Vessels involved the aorta (4), as well as hepatic (1), splenic (2), gastroepiploic (1), renal (12), iliac (1), superficial femoral (4), popliteal (1), brachial (1), radial (2), and ulnar (2) arteries. Twelve children exhibited overt clinical manifestations including presence of a mass (7), local pain (3), hematemesis (1), and painless obstructive jaundice (1). Eleven children had asymptomatic lesions. Aneurysm existence was confirmed by arteriography or operation. All but one child underwent surgical therapy, with 20 long-term survivors (mean follow-up 3.5 years). One operative death occurred and one death occurred 6 years after surgery. This experience and a review of previously reported cases served as a basis for categorization of childhood aneurysmal disease as true aneurysms associated with (I) arterial infection, (II) giant-cell aortoarteritis, (III) autoimmune connective tissue disease, (IV) Kawasaki's disease, (V) Ehlers-Danlos syndrome or Marfan's syndrome, (VI) other forms of noninflammatory medial degeneration, (VII) arterial dysplasias, (VIII) congenital-idiopathic factors, as well as (IX) false aneurysms associated with extravascular events causing vessel wall injury or disruption. Knowledge of the varied clinicopathologic characteristics of arterial aneurysms in children is important in treating these patients.
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            THROMBOANGIITIS OBLITERANS

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              Pediatric nonaortic arterial aneurysms

              Pediatric arterial aneurysms are extremely uncommon. Indications for intervention remain poorly defined and treatments vary. The impetus for this study was to better define the contemporary surgical management of pediatric nonaortic arterial aneurysms.
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                Author and article information

                Contributors
                Journal
                Case Rep Med
                Case Rep Med
                CRIM
                Case Reports in Medicine
                Hindawi
                1687-9627
                1687-9635
                2020
                20 May 2020
                : 2020
                : 9198723
                Affiliations
                1Department of Pediatric Surgery, Kazan Medical University, Kazan, Russia
                2Department of Cardiovascular Surgery, Children's Republican Hospital, Kazan, Russia
                3Department of Pediatric Surgery, St Georges Hospital NHS Trust, London, UK
                Author notes

                Academic Editor: Omer Faruk Dogan

                Author information
                https://orcid.org/0000-0002-1023-1158
                https://orcid.org/0000-0002-4850-6540
                Article
                10.1155/2020/9198723
                7260628
                99e20a3b-9913-4592-b642-6365b2c6baaf
                Copyright © 2020 Ildar Nurmeev et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 June 2019
                : 12 May 2020
                Categories
                Case Series

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