Resection of redundant segment in ulnar artery kinking with subsequent autologous prosthetic repair

Authors

Keywords:

ulnar artery, kinking, autologous prosthesis

Abstract

Introduction: Kinking of the distal ulnar artery is a vascular anomaly characterized by abnormal twists or folds in an artery, associated with advanced age, female sex, hypertension, and other cardiovascular  factors. It is very rare and its prevalence is less than 1 %. It had not been reported to the service before.

Objective: To present the case of a patient diagnosed with kinking of the distal ulnar artery, with another therapeutic option.

Clinical Case: A 57-year-old Caucasian male from an urban area with a history of hypertension had previously presented with asymptomatic enlargement of the left wrist and symptoms of cramping, numbness, and moderate pain in the hand over the past 6 months, suggesting compression of the ulnar nerve due to a possible aneurysm. Physical examination revealed a pulsatile mass in the wrist (synchronous with the heart rate, without a murmur). Imaging (doppler): tortuosity with multiple kinks in the ulnar artery (kinking), without aneurysm. Final diagnosis: kinking of the ulnar artery. Surgical treatment: resection of the tortuous segment plus autologous cephalic vein graft. Outcome: favorable, with follow-up in the outpatient clinic.

Conclusion: Kinking of the ulnar artery is rare, but should be considered in cases of unexplained pain or digital ischemia. Among the therapeutic options, the use of a cephalic vein as a prosthesis to maintain perfusion is considered (as opposed to traditional ligation).

References

1. Del Corso L, Moruzzo D, Conte B, Agelli M, Romanelli AM, Pastine F, et al. Tortuosidad, kinking, y enrollado de la arteria carótida: ¿expresión de aterosclerosis o envejecimiento? Angiología. 1998; 49:361-71. DOI: 10.1177/0003319798080

2. Cha KS, Kim MH, Kim HJ. Prevalencia y predictores clínicos de tortuosidad grave de la arteria subclavia derecha en pacientes sometidos a coronariografía transradial. Am J Cardiol. 2003; 92:1220-122. Disponible en: https://www.ajconline.org/article/S0002-9149(03)01140-8/abstract

3. Safeek RH, O'Toole A, Furtado WR, Wilhemi BJ, Choo JH. Isolated Ulnar Artery Injury: Indications for and Timing of Operative Intervention. Eplasty. 2022;22:e37. Published 2022 Aug 24. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC9490881/

4. Zheng, Y, Zheng, W, Guo H. Increased Internal Carotid Artery Tortuosity is a Risk Factor for Spontaneous Cervicocerebral Artery Dissection. European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery. 2021; 61(4):542–549. Disponible en: https://pubmed.ncbi.nlm.nih.gov /33402322/

5. Kim ST, Brinjikji W, Lehman V T, Carr C M, Luetmer PH, Rydberg CH. Association between carotid artery tortuosity and carotid dissection: a case-control study. Journal of neurosurgical sciences. 2018; 62(4): 413–417. DOI: https://doi.org/10.23736/S0390-5616.16.03790-5

6. Casey RT, Like BJ. Digital Ischemia Secondary to Ulnar Artery Puncture Successfully Treated by Brachial Plexus Block: A Case Report. A&A practice. 2025; 19 (1): e01907. Disponible en: https://journals.lww.com/aacr/abstract/2025/01000/digital_ischemia_secondary

_to_ulnar_artery.17.aspx

Downloads

Published

2025-08-12

How to Cite

1.
Basile Romero L, Aranda Dámaso J, Antonio Salgado Delgado L. Resection of redundant segment in ulnar artery kinking with subsequent autologous prosthetic repair. Invest Medicoquir [Internet]. 2025 Aug. 12 [cited 2025 Dec. 5];17(1):e993. Available from: https://revcimeq.sld.cu/index.php/imq/article/view/993

Issue

Vol. 17 No. 1 (2025): in progress

Section

Case presentation

License

Copyright (c) 2025 Leonardo Basile Romero, Jaroslay Aranda Dámaso, Leonardo Antonio Salgado Delgado

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

The authors retain copyright and all unrestricted publication rights.

Medicoquirúrgicas Research is licensed under the Creative Commons Attribution-Noncommercial 4.0 International License (CC BY-NC 4.0) and follows the SciELO Publishing Schema (SciELO PS) for publishing in XML format.

You are free to:

  • Share — copy and redistribute the material in any medium or format.
  • Adapt — remix, transform, and build upon the material.

The license cannot revoke these freedoms as long as you follow the license terms.

Under the following terms:

  • Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do this in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.

Non-Commercial — You may not use the material for commercial purposes.
No Additional Restrictions — You may not apply legal terms or technological measures that legally restrict others from making any use permitted by the license.

Notices:

You do not have to comply with the license for elements of the material in the public domain or where their use is permitted by an applicable exception or limitation.
No warranties are given. The license may not give you all the permissions you need for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.