Axillary Artery Pseudoaneurysm Secondary to Septic Shoulder After Trauma: A Review of Incidence and Outcomes

TL;DR

This review examines rare axillary artery pseudoaneurysms caused by trauma or septic shoulder infections, highlighting the importance of early diagnosis and surgical treatment to prevent severe complications.

Contribution

The study provides a systematic review of incidence, clinical features, and outcomes of axillary artery pseudoaneurysms following trauma or septic shoulder.

Findings

AAP is rare but can lead to limb loss if untreated.

Traumatic AAP is often linked to shoulder dislocation or sports injuries.

Surgical repair is effective for limb salvage and neurological recovery.

Abstract

Axillary artery pseudoaneurysm (AAP) is a rare vascular complication arising from trauma or septic shoulder conditions. Its proximity to the brachial plexus and axillary structures increases the risk for neurovascular compromise, hemorrhage, and limb loss. This review aims to evaluate the incidence, clinical characteristics, and outcomes of AAP secondary to trauma and septic shoulder infection. A systematic literature search was conducted in PubMed, Embase, Scopus, and the Cochrane Library through October 2025 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible studies included case reports and series reporting AAP after trauma or septic shoulder. Data on patient demographics, etiology, diagnostic methods, management, and outcomes were extracted and qualitatively synthesized. Five studies comprising 14 patients met the inclusion criteria. Traumatic AAP was most commonly associated with anterior shoulder dislocation, blunt trauma, or repetitive sports injuries, while septic transformation occurred via hematogenous or contiguous spread. Clinical presentation included a pulsatile axillary mass, limb swelling, and neurological deficits. Surgical repair, including open reconstruction and vein grafting, achieved successful limb salvage and neurological recovery in most cases. Septic pseudoaneurysms demonstrated higher morbidity, with delayed intervention linked to soft tissue destruction and increased complication risks. AAP secondary to trauma or septic shoulder is uncommon but potentially life-threatening. Early recognition, imaging, and timely surgical intervention are essential to optimize limb function and survival. Multidisciplinary management is recommended for improved outcomes.

Figures