Emergent Treatment of Ruptured Axillary Artery Aneurysm

The axillary artery aneurysm (AxAA) is a rare entity, with a diverse range of proposed etiologic mechanisms. Although usually asymptomatic, thromboembolic or hemorrhagic complications leave many with vascular and neurologic compromise. Both open and endovascular treatment approaches have been reported. However, no consensus has been reached on the management of AxAAs. This case illustrates a unique emergent treatment approach for a ruptured AxAA, involving endovascular plugging and immediate subsequent open hematoma evacuation. Although there was no restoration of vessel continuity, reasonable recovery of motor function on follow-up suggests this treatment approach may be considered in emergent settings.