Acute upper limb ischemia secondary to crutch-induced brachial artery aneurysm

Presentation of upper limb ischemia in patients with long-term crutch use warrants suspicion of proximal aneurysmal degeneration with distal thromboembolization. We present a case of a 63-year-old man with a history of chronic axillary crutch use due to childhood poliomyelitis who presented with acute left-hand ischemia. Computed tomography angiography identified a left brachial artery aneurysm, which was determined to be the etiology of the thromboembolic event. The aneurysm was successfully excluded with an axillary-to-brachial artery bypass using the greater saphenous vein. He recovered well without complications and transitioned to ergonomic gait aids to prevent recurrent aneurysmal degeneration and subsequent embolization.