Jornal Vascular Brasileiro
Jornal Vascular Brasileiro
Therapeutic Challenge

Management of traumatic superficial palmar arch pseudoaneurysm: a therapeutic challenge

Patrick Bastos Metzger; Fernando Antonio Falcão Paixão Neto; Sarah Fernandez Coutinho de Carvalho; Miguel Godeiro Fernandez; Simone Lessa Metzger; Maria Fernanda Lima Brandão; Rafael Borges Monteiro; Fabio Henrique Rossi

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Pseudoaneurysm of the palmar arch is a rare entity. Diagnosis is dependent on high clinical suspicion. We present a case referred to the emergency department, with a history of glass penetrating trauma to the palmar surface with a pulsatile mass and jet bleeding. Doppler ultrasound evidenced a partially thrombosed pseudoaneurysm. A CT angiography examination showed a saccular formation arising from the superficial palmar arch. A conventional surgical approach was indicated. A clinical suspicion must be ventured to arrive at the correct diagnosis. Imaging modalities are needed to identify the pseudoaneurysm and plan the treatment course. Nonetheless, the sequence of diagnosis is individual, because further evaluation with different imaging methods may not change the rationale for the intervention. In our experience, conventional surgical removal is preferable, due to its safety and well-established outcomes.


vascular injury, pseudoaneurysm, hand injury, bleeding


1 Schoretsanitis N, Moustafa E, Beropoulis E, Argyriou C, Georgiadis G, Georgakarakos E. Traumatic pseudoaneurysm of the superficial palmar arch: a case report and review of the literature. J Hand Microsurg. 2015;7(1):230-2. PMid:26078551.

2 Bosman A, Veger HTC, Doornink F, Joosten PPAH. Pseudoaneurysm of the deep palmar arch after penetrating trauma to the hand: successful exclusion by ultrasound guided percutaneous thrombin injection. EJVES Short Rep. 2016;31:9-11. PMid:28856301.

3 Krüger K, Zähringer M, Söhngen FD, et al. Femoral pseudoaneurysms: management with percutaneous thrombin injections - success rates and effects on systemic coagulation. Radiology. 2003;226(2):452-8. PMid:12563139.

4 Hughes CD, Binette C, Babigian A. Pseudoaneurysm in the hand of a three-year-old boy: a case report. J Emerg Med. 2012;42(4):e87-9. PMid:21435814.

5 Megalopoulos A, Siminas S, Trelopoulos G. Traumatic pseudoaneurysm of the popliteal artery after blunt trauma: case report and a review of the literature. Vasc Endovascular Surg. 2007;40(6):499-504. PMid:17202099.

6 Zarzecki MP, Popieluszko P, Zayachkowski A, Pękala PA, Henry BM, Tomaszewski KA. The surgical anatomy of the superficial and deep palmar arches: a meta-analysis. J Plast Reconstr Aesthet Surg. 2018;71(11):1577-92. PMid:30245020.

7 Singh S, Lazarus L, Gama BZ, Satyapal KS. An anatomical investigation of the superficial and deep palmar arches. Folia Morphol. 2017;76(2):219-25. PMid:27665957.

8 Mohler ER III, Mitchell ME, Carpenter JP, et al. Therapeutic thrombin injection of pseudoaneurysms: a multicenter experience. Vasc Med. 2001;6(4):241-4.

9 Kwiecien GJ, Garbuzov A, Boonipat T, Houdek MT, Moran SL. Pseudoaneurysm of the superficial palmar arch in a 6-month-old child: a case report. Plast Reconstr Surg Glob Open. 2022;10(2):e4093. PMid:35169525.

10 Andacheh I, Chamseddin K, Kirkwood ML. Management of lateral plantar artery pseudoaneurysm after penetrating injury in children. Vasc Endovascular Surg. 2015;49(8):247-9. PMid:26647428.

11 Sakamoto A, Arai K. False aneurysm of the superficial palmar arch in a child: a case report. Cases J. 2009;2(1):7985. PMid:19830035.

12 Bouvet C, Bouddabous S, Beaulieu JY. Aneurysms of the hand: imaging and surgical technique. Hand Surg Rehabil. 2018;37(3):186-90. PMid:29567084.

13 Cozzi DA, Morini F, Casati A, Pacilli M, Salvini V, Cozzi F. Radial artery pseudoaneurysm successfully treated by compression bandage. Arch Dis Child. 2003;88(2):165-6. PMid:12538327.

14 Monteiro RB, Metzger PB, Moura AB, et al. Traumatic pseudoaneurysm in brachial artery after removal of a subdermal contraceptive implant. J Vasc Bras. 2020;19:e20200040. PMid:34211515.

15 Ladeira FN, Quintella AHS, Carvalhido LT, et al. Pseudoaneurisma pós-traumático de artéria plantar medial em criança: tratamento percutâneo com injeção de trombina. J Vasc Bras. 2014;13(1):43-7.

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