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Page 6 of 7 Kishi. Plast Aesthet Res 2020;7:3 I http://dx.doi.org/10.20517/2347-9264.2019.50

Eleven of the fifteen cases described were on the left side.

One of the cases in which the aneurysm occurred in the dominant hand was a right-sided aneurysm in
a 12-year-old boy; one patient was very young, and investigators could not judge the dominant hand.
Our case was not identified as occurring in the dominant side on the first visit; however, one year later, it
appeared that the dominant side was the right side.

The age of onset ranged from 5 months to 16 years with a mean of six years, Treatment was carried out
in all 15 cases. Simple excision was performed for eight cases and reconstruction for seven cases; one
needed end-to-end anastomosis, five needed vein graft, and one needed a combination with sclerotherapy.
Embolization was not selected because it may impair blood flow in the common digital arteries. We chose
to use a vein graft from the saphenous vein because there was a 2-cm diameter gap between the affected
arteries; the aneurysm was located at the edge of the deep palmar arch; and the mobility of the ulnar artery
was poor. If the distance between the defect of the artery had been short, we could have directly sutured
the artery. The donor vein was difficult to anastomose because its diameter was one-third that of the ulnar
artery. Furthermore, it was difficult to obtain a good vein to fit the diameter of the recipient artery from
a nine-month-old boy with minimal injury because the fat layer at that region around the saphenous
vein was thick and therefore the resulting wound was considerably longer. Two cases in the literature
had a history of collagen disease, namely Kawasaki disease, Marfan’s syndrome, Loeys-Dietz syndrome,
osteogenesis imperfect, and Ehlers-Danlos syndrome. Our patient had no evidence of these diseases. We
diagnosed this as a congenital aneurysm in the palm because it was a true aneurysm, with poor infiltration,
no arterial sclerosis on pathological findings, and no evidence of collagen disease or trauma.

In conclusion, arterial aneurysms of the palm in the pediatric population are rare. Our case was a right-
handed seven-month-old boy. The patient underwent operative exploration with arterial reconstruction
to interpose between the defect using a dorsal pedal vein. The patient recovered well without any
complication. Including the present case, there have been only 16 cases of congenital aneurysms in the
palm.

DECLARATIONS
Authors’ contributions
The author contributed solely to the article.

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
The author declared that there are no conflicts of interest.

Ethical approval and consent to participate
This study was condacted in accordance with the declaration of Helsinki.

Consent for publication
Not applicable.