Idiopathic true saccular aneurysm of the right radial artery

Aneurysms of the radial artery are fairly common considering the rise in radial artery catheterization and other forms of trauma. The majority of these are, however, pseudoaneurysms. True aneurysms involving the radial artery are, however, very rare. Here, we report a true saccular aneurysm involving the distal right radial artery in a female with ulnar artery dominance managed by ligation and excision. A 35-year-old woman who presented with a right distal forearm swelling of 6-year duration and 8-month history of pain, with no prior history of trauma to the forearm, and no comorbidities. She was found to have a 2 cm × 2 cm mass in her right lateral distal forearm, 8 cm from the wrist joint. It was nontender with expansile pulsation. Allen's test revealed ulnar artery dominance. A duplex ultrasound scan revealed aneurysm of the right radial artery. The patient subsequently had ligation of the radial artery and excision of the aneurysm sac under local anesthesia. Histology revealed true aneurysm of the radial artery. Idiopathic true aneurysm of the radial artery is rare and can remain asymptomatic for a long time, and arterial ligation and aneurysm excision are safe in the presence of ulnar artery dominance.