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Multiple aneurysms of the radial artery in a woman with neurofibromatosis type 1 presenting as aneurysm rupture  Francesco De Santis, MD, PhD, Giovanni.

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Presentation on theme: "Multiple aneurysms of the radial artery in a woman with neurofibromatosis type 1 presenting as aneurysm rupture  Francesco De Santis, MD, PhD, Giovanni."— Presentation transcript:

1 Multiple aneurysms of the radial artery in a woman with neurofibromatosis type 1 presenting as aneurysm rupture  Francesco De Santis, MD, PhD, Giovanni Negri, MD, Guido Martini, MD, Guido Mazzoleni, MD  Journal of Vascular Surgery  Volume 58, Issue 5, Pages (November 2013) DOI: /j.jvs Copyright © 2013 Society for Vascular Surgery Terms and Conditions

2 Fig 1 A, Significant swelling of the right forearm is seen preoperatively. Two neurofibromas are evident near the elbow and the wrist (large arrows). Note the forearm compartment skin tension. B, The multislice spiral computed tomography three-dimensional reconstruction shows multiple small fusiform radial artery (RA) aneurysms and a high ulnar artery origin from the brachial artery in the arm. The more proximal aneurysm is located ∼3 cm below the anomalous brachial artery bifurcation. Note the RA and the interosseous artery are spread apart by a large hematoma in the forearm (*). C, The multislice computed tomography angiography shows arterial wall irregularities in the RA at the proximal aneurysm level, indicative of arterial continuity interruption (large arrow). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

3 Fig 2 A, After large hematoma evacuation, the radial artery (RA) presented completely sectioned at the ruptured RA aneurysm level; RA stumps were partially retracted in the forearm (small arrows). The distal RA stump is located immediately before the ruptured aneurysm (*). Note the anomalous brachial artery bifurcation. A collateral vessel stemming from the RA before the aneurysm is also evident (large arrow). The RA surface shows a markedly edematous and fragile vessel wall. B, The intraoperative angiographic control performed before RA ligation shows multiple fusiform RA aneurysms (large arrows) distally to the ruptured aneurysm and a good satisfactory blood supply to the hand from an independent ulnar artery (UA). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

4 Fig 3 A, Hematoxylin and eosin staining of the radial artery shows spindle-shaped cell proliferation in the adventitia (arrow). B, Hematoxylin and eosin stain of the forearm vein shows the infiltration by the same cell proliferation as in the radial artery (arrow). C, S100 immunohistochemistry shows partial positivity of the spindle cells (arrow). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

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