Pseudoaneurysm of the brachial artery: a rare complication of blood donation

Abstract

Serious complications of blood donation are rare. Reported here is a significant vascular event that resulted from whole-blood phlebotomy and required surgical repair. A 49-year-old woman donated whole blood without incident in November 1992, but reported ecchymosis and tenderness in the antecubital area of the right arm immediately following the procedure (her medical history was unremarkable). Over the next several days, the ecchymosis extended to the axilla and she complained of numbness in all her fingers, particularly the thumb and adjacent two fingers of the involved side. Coincident to these findings, an egg-sized lump developed under the skin at the phlebotomy site. Her symptoms and the mass persisted for several weeks. Examination and ultrasound performed in January 1993 demonstrated a pulsatile mass over the brachial artery. The donor underwent an exploratory surgical procedure that revealed a 3.3 x 2.5 x 2.0-cm pseudoaneurysm of the brachial artery. Unlike a true aneurysm, this lesion was composed only of a blood clot that was compressing the outer wall of the artery. A pinpoint-sized hole was seen in the artery when the lesion was excised. The phlebotomy is believed to have caused blood to leak out of the artery, creating the lesion and exerting pressure on the median nerve. Pseudoaneurysm of the femoral artery is a well-documented complication of cardiac catheterization and other invasive arterial procedures, but this is the first known reported case following blood donation. Blood collectors should be made aware of this potentially serious complication of blood donation.