A rare complication after blood donation: Brachial artery ps
Pseudoaneurysm of brachial artery following whole blood donation is a very rare complication due to inadvertent arterial puncture. Published in the Indian Journal of Vascular and Endovascular Surgery the authors describe this rare event in a young male whole blood donor presenting 2 months after blood donation with pulsatile swelling in the right antecubital fossa and paresthesia of hand. He was successfully managed with surgical intervention.

A 20-year-old male presented with a history of progressively increasing swelling in the right antecubital fossa of 2 months duration. It was associated with tingling sensation in hand and constant aching pain aggravated by movement of elbow joint. He gives a history of blood donation 2 months back following which he developed bruise and swelling which was managed conservatively with local compression; however, it progressively increased in size. It was his first blood donation.

On examination, there was 6 cm × 6 cm tense pulsatile swelling in the medial aspect of the right antecubital fossa. Duplex examination showed large hematoma with Ying—Yang flow in central zone arising from brachial artery suggestive of pseudoaneurysm. Ultrasound-guided compression was attempted; however, it was unsuccessful. Surgical repair was planned, as hematoma was large and tense causing pain and paresthesia due to local nerve compression.

He was operated under local anesthesia with 1% lignocaine. Proximally brachial artery was dissected, and control was taken with arterial sling after heparinization. Horizontal incision was made over the swelling in antecubital fossa and deep fascia (bicipital aponeurosis) was incised, releasing the tense hematoma lying below it.

After the evacuation of hematoma, a 2 mm hole in brachial artery above the bifurcation was visualized there was no other superficial artery, and course of brachial artery was normal. The hole was repaired primarily by oversewing with 6.0 polypropylene suture. Postoperatively, his pain and paresthesia subsided and is on regular follow-up without any complaints.

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