Repair of a symptomatic true radial artery aneurysm at the anatomic snuff box with interposition great saphenous vein graft

Radial artery aneurysms are exceedingly rare, with only a few reported cases of surgical revascularization. We describe a 25-year-old man who presented with severe ischemia of the right hand secondary to an idiopathic true radial artery aneurysm at the anatomic snuff box. The patient had embolic occlusions in his hand and fingers that were treated with catheter-directed thrombolysis. During angiography, the blood supply to the affected hand was determined to be radial artery dominant, and therefore the aneurysm was resected and revascularized using an interposition great saphenous vein graft. The patient denied ischemic symptoms postoperatively, and duplex ultrasound examination at a 10-month follow-up showed patent interposition graft.