A Rare Case of Brachial Artery Aneurysm in a 9-Month-Old Infant.

An otherwise healthy 9-month-old infant was treated for a true aneurysm of the proximal brachial artery. The swelling was first noted at seven months of age. An ultrasound scan showed a 2 cm × 2 cm aneurysm of the left brachial artery at the level of the mid-upper arm. Whole-body magnetic resonance angiography (MRA) confirmed this was a true aneurysm of the brachial artery; there was good distal runoff and no other aneurysms elsewhere. Vasculitis screen was negative. Surgical excision of the aneurysm and reconstruction of the brachial artery was performed with a reversed cephalic vein graft. The patient made an uneventful recovery and was discharged home. We present an overview of the workup report and emphasise that a multi-disciplinary team approach is imperative for assessing and managing this rare condition.

The posterior approach to the thoracodorsal vessels for microsurgical free tissue transfer.

The latissimus dorsi (LD) muscle is a workhorse flap in reconstructive surgery (e.g., breast reconstruction, chest wall defects, and lower limb trauma). The thoracodorsal artery and its venae comitantes supply this muscle. Recipient vessel options for microsurgical free flap reconstruction of the posterior thorax and lower back are limited. The thoracodorsal vessels are an excellent option due to their reliable anatomy and ease of access. In circumstances when the patient is best positioned prone, the posterior approach to access the thoracodorsal vessels is advantageous. We describe the technique to identify and isolate these vessels via a posterior approach.