scholarly journals 46. Aneurism of the external Iliac artery???obscurity delaying an operation???mortification of the limb???ligature of the common Iliac, and amputation of the thigh???dissection

1839 ◽  
Vol 46 (2) ◽  
pp. 488
Author(s):  
&NA;
Keyword(s):  
Iliac Artery ◽  
External Iliac Artery ◽  
The Common

Successful and Unsuccessful Blind Placement of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) Catheters Through Damaged Arteries: A Report of Three Cases

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Philip Joseph Wasicek ◽  
William A Teeter ◽  
Peter Hu ◽  
Deborah M Stein ◽  
Thomas M Scalea ◽  
...  
Keyword(s):  
Iliac Artery ◽  
External Iliac Artery ◽  
Common Femoral Artery ◽  
Arterial Injury ◽  
Balloon Occlusion ◽  
Tactile Feedback ◽  
Balloon Inflation ◽  
Iliac Arteries ◽  
Tertiary Center ◽  
The Common

Background: Patients who receive REBOA for temporization of exsanguinating hemorrhage may have occult injuries sustained to the iliac arteries or aorta which may pose increased risks in performing REBOA. There is a paucity of literature describing the successful blind placement of wires and/or catheters for REBOA through damaged vasculature. Methods: Patients admitted between February 2013 and July 2017 at a tertiary center who had a successful or unsuccessful blind placement of a REBOA catheter or wire through a damaged iliac artery or aorta were included. Results: Three patients were identified. Two patients had successful placement of the REBOA catheter; one sustained injury to the external iliac artery, and the other sustained injury to the abdominal aorta. Confirmation of catheter placement was obtained before balloon inflation; and the damaged vessels were identified upon immediate operative intervention. One patient had unsuccessful placement of the REBOA catheter during cardiac arrest despite accurate access of the common femoral artery (CFA).  Conclusions: Emergent, blind placement of wires and catheters past arterial injuries is possible. Physical exam and/or tactile feedback should alert the surgeon to the possibility of arterial injury and imaging confirmation should precede balloon inflation if at all possible to minimize risk of further vascular injury.

Determination of the Best Parameter for Defining the Hemodynamic Significance of an Iliac Artery Stenosis Detected on Computed Tomography Angiography

2016 ◽  
Vol 67 (3) ◽  
pp. 298-303
Author(s):  
Nick Lougheed ◽  
Jeff Jaskolka ◽  
Rob Beecroft ◽  
Ravi Menezes
Keyword(s):  
Computed Tomography ◽  
Iliac Artery ◽  
Computed Tomography Angiography ◽  
External Iliac Artery ◽  
Artery Stenosis ◽  
Minimum Diameter ◽  
Significant Stenosis ◽  
Iliac Artery Stenosis ◽  
The Common ◽  
Best Parameter

Purpose The purpose of this study was to determine the best parameter, derived from computed tomography angiography (CTA) for accurate prediction of a hemodynamically significant stenosis of the common or external iliac artery. Methods A retrospective keyword search was performed on the Radiology Information System at our tertiary academic medical centre. Reports from January 2008 to September 2013 were searched using the keywords iliac, stenosis, and pressure. Patients who had both and CTA and a pelvic angiogram with pressure measurements obtained across a potential stenosis were selected. Using 3D postprocessing software (TeraRecon, Foster City, CA), the CTAs were analysed for the following parameters of each lesion: minimum diameter of stenosis, minimum cross-sectional area of stenosis, percent narrowing of vessel diameter, and percent reduction in vessel area. The percent stenosis was calculated in reference to the outer diameter at the point of maximal narrowing and also in reference to a normal segment of vessel more distal to the stenosis. These parameters were then compared with the measured pressure gradient using receiver-operating characteristic analysis and the Mann-Whitney U test to determine which best predicted a significant stenosis, defined as a greater than 10% drop in systolic pressure across a lesion. Results One hundred and two stenoses in 83 patients (26 women, 57 men; 47-88 years old) were identified. Mean diameter of the stenosis was 2.8 mm for significant stenosis compared to 3.8 mm in nonsignificant stenoses ( P = .005). Mean minimum area for significant stenoses was 11.8 mm2 compared to 17.22 mm2 for nonsignificant stenoses ( P = .032) No other variables showed a significant difference between significant and nonsignificant stenoses. A minimum diameter of ≤4.0 mm at the level of a stenosis is 92% sensitive and 48% specific for predicting a hemodynamically significant iliac artery stenosis, with a positive predictive value of 88%. Conclusions A simple measurement of the minimum diameter of an iliac artery at the level of stenosis is the best predictor of the hemodynamic significance of a stenosis in the common or external iliac artery.

scholarly journals BRANCHING PATTERN OF FETAL INTERNAL ILIAC ARTERY. PATRÓN DE RAMIFICACIÓN DE LA ARTERIA ILÍACA INTERNA FETAL

2016 ◽  
Vol 2 (3) ◽  
pp. 100-105 ◽  
Author(s):  
Sumathilatha Sakthivelavan ◽  
Sakthivelavan D Sendiladibban ◽  
Christilda Felicia
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
External Iliac Artery ◽  
Branching Pattern ◽  
Inferior Gluteal Artery ◽  
Internal Pudendal Artery ◽  
Superior Gluteal Artery ◽  
Branching Patterns ◽  
Internal Iliac ◽  
The Common

Objetivo: Estudiar el patrón de ramificación de la arteria ilíaca interna del feto y que son equivalentes a la disposición de las ramas ilíacas internas en los adultos. Métodos: Veinticuatro mitades de pelvis fueron utilizados como muestras. Que se obtuvieron de fetos nacidos muertos, de 5 a 9 meses de edad gestacional. Resultados: la arteria ilíaca interna está en consonancia con la arteria ilíaca común y más grande que la arteria ilíaca externa. Tres tipos de ramificación se observaron sobre la base de las grandes ramas, a saber, la arteria glútea inferior, la arteria pudenda interna y la arteria glútea superior. Los resultados se correlacionaron con los patrones de ramificación descriptos por Piersol (1930). Conclusión: La disposición más común, tenía dos grandes troncos procedentes de la arteria iliaca interna, la posterior era la arteria glútea superior y la anterior se dividía en arterias pudenda y glútea inferior. Los otros patrones conducen variables en los adultos que son de importancia embriológicos y quirúrgicos. Objective: To study the branching pattern of fetal internal iliac artery and to correlate with the arrangement of the internal iliac branches in adults. Methods: Twenty four pelvic halves were used as specimens. They were obtained from the dead born fetuses of 5 to 9 months of gestational age. Results: Internal iliac artery was in line with the common iliac artery and larger than the external iliac artery.  Three types of branching were observed based on the large branches namely inferior gluteal artery, internal pudendal artery and superior gluteal artery. The findings were correlated with the patterns of branching described by Piersol (1930). Conclusion: The most common arrangement had two large trunks originating from internal iliac artery, the posterior one being superior gluteal artery and the anterior one divided into internal pudendal and inferior gluteal arteries. The other patterns lead to variable branching patterns in adults that are of embryological and surgical significance. 

Emergent conversion of the Ovation Stent Graft System to aortouniiliac modification via occlusion of a unilateral internal iliac artery with a stentgraft as a bailout solution

Vascular ◽  
2015 ◽  
Vol 23 (4) ◽  
pp. 440-443 ◽  
Author(s):  
Efstratios Georgakarakos ◽  
Nikolaos Schoretsanitis ◽  
Vasileios D Souftas ◽  
Chris Argyriou ◽  
Erchan Moustafa ◽  
...  
Keyword(s):  
Stent Graft ◽  
Iliac Artery ◽  
Internal Iliac Artery ◽  
External Iliac Artery ◽  
Covered Stent ◽  
Contralateral Limb ◽  
Internal Iliac ◽  
Crossover Bypass ◽  
The Common ◽  
Femorofemoral Bypass

Purpose To present a case of inadvertent collapse of the contralateral limb gate caused by misorientation during the deployment of the Ovation Abdominal Stent Graft System in a narrow aortic lumen and the bailout conversion to aortouniiliac modification, using a covered stent to exclude the orifice of the internal iliac artery (IIA). Technique description Despite the repeated efforts from the femoral and brachial site, the collapsed/occluded contralateral limb gate could not be catheterized. In order to exclude successfully the orifice of the IIA, an oversized stentgraft was placed immediately at the common-to-external iliac artery (CIA-EIA) transition followed by peripheral ligation of the latter. The procedure was completed with crossover femorofemoral bypass. Conclusion Occlusion the IIA orifice with an oversized stentgraft in the CIA-EIA transition can be considered as a safe, simple, fast, and efficient bailout maneuver, followed by EIA ligation and crossover bypass.

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