Exercise induced brachial artery pseudoaneurysm treated by balloon assisted direct human thrombin injection: A case report

Push up induced brachial artery pseudo aneurysm (BAPA) in the antecubital fossa is rare. When there is involvement of the ulnar and radial artery, percutaneous closure using thrombin is preferred to surgery or covered stent. A 52-year-old man, known hypertensive on angiotensin receptor blocker, presented with a giant right antecubital fossa pseudo aneurysm after a push-up exercise. The neck of the aneurysm was located where the brachial artery was dividing into UA and RA. Ultrasound guided neck compression had no effect. A staged direct thrombin injection thrombosed the sac. A follow period of 15 months showed normal flow in the BA, RA, and UA.