Bilateral axillary artery aneurysm in a patient with end‑stage renal disease: sequential surgical management: A case report

Background: Axillary artery aneurysms are rare, accounting for less than 1% of peripheral arterial aneurysms. Bilateral involvement is exceptional.
Case presentation: We report the case of a 63-year-old woman with hypertension and end-stage renal disease who presented with a progressively enlarging pulsatile mass in the right axilla. She had previously undergone surgical repair of a left axillary artery aneurysm 15 months earlier. Computed tomography angiography revealed a large partially thrombosed fusiform aneurysm of the right axillary artery extending to the proximal humeral artery. Surgical treatment consisted of aneurysm exclusion and axillo-humeral bypass using a ring-reinforced PTFE graft.
Results: The postoperative course was uneventful, with preserved distal pulses. Doppler ultrasound at one-month follow-up confirmed satisfactory graft patency.
Conclusion: Bilateral axillary artery aneurysms are extremely rare. Early diagnosis and surgical management are essential to prevent complications. Long-term surveillance is required, particularly in patients with chronic renal disease.