scholarly journals Collateral development and arteriogenesis in hindlimbs of domestic swine after ligation of arterial inflow

2018 ◽  
Author(s):  
NS Patel ◽  
Y Gao ◽  
S Aravind ◽  
M Fuglestad ◽  
GP Casale ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Hindlimb Ischemia ◽  
Artery Ligation ◽  
Luminal Diameter ◽  
Internal Iliac ◽  
Collateral Pathways ◽  
The Common ◽  
The Right ◽  
Domestic Swine

ABSTRACTIntroductionThe development of collateral vasculature is a key mechanism compensating for arterial occlusions in patients with peripheral artery disease (PAD). We aimed to examine the development of collateral pathways after ligation of native vessels in a porcine model of PAD.MethodsRight hindlimb Ischemia was induced in domestic swine (N=11, male, kg) using two different versions of arterial ligation. Version 1 (N=6) consisted of ligation/division of the right external iliac, profunda femoral (RPFA) and superficial femoral arteries (RSFA). Version 2 (N=5) consisted of the ligation of Version 1 with additional ligation/division of the right internal iliac artery (RIIA). Development of collateral pathways was evaluated with standard angiography at baseline (prior to arterial ligation) and at termination (4-8 weeks later). Relative luminal diameter of the arteries supplying the ischemic right hindlimb were determined by 2D angiography, as percent of the size of the distal aortic diameter.ResultsThe dominant collateral pathway that developed after version 1 ligation connected the RIIA to the RPFA and RSFA/popliteal artery. Mean luminal diameter (± standard error) of the RIIA at termination increased by 38% (P<0.05) compared to baseline. Two co-dominant collateral pathways developed in version: (i) from the common internal iliac trunk and left internal iliac artery to the reconstituted RIIA, which then supplied the RPFA and RSFA/popliteal arteries; and (ii) from left profunda artery to the reconstituted RPFA. Mean diameter of the common internal iliac trunk and left profunda artery both increased at termination in the range of 20% (p < 0.05).ConclusionTwo versions of hindlimb ischemia induction (right ilio-femoral artery ligation with and without right internal iliac artery ligation in swine produced differing collateral pathways, along with changes to the diameter of the inflow vessels (i.e., arteriogenesis). Radiographic and anatomical data of the collateral formation in this porcine model should have value in investigation of the pathophysiology of hindlimb ischemia, and assessment of angiogenic therapies as potential treatments for PAD.

Internal Iliac Artery Ligation: A Retrospective Analysis of Two Different Approaches

2017 ◽  
Vol 9 (3) ◽  
pp. 230-234
Author(s):  
GS Jyothi
Keyword(s):  
Retrospective Analysis ◽  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Common Iliac Artery ◽  
Round Ligament ◽  
Artery Ligation ◽  
Internal Iliac Artery Ligation ◽  
Internal Iliac ◽  
Pouch Of Douglas ◽  
The Common

ABSTRACT Aim To describe two different approaches of performing internal iliac artery ligation and their usefulness in different clinical situations. Introduction Internal iliac artery ligation is a very useful method to control pelvic hemorrhage. It can become a necessity at any point of time while performing obstetric or gynecological surgeries, and it is a procedure that needs to be accomplished in a matter of few minutes, before the patient goes into irreversible shock. Techniques Internal iliac artery ligation can be done by approaching the artery by opening the retroperitoneal space, either by dividing the round ligament or by opening the pouch of Douglas. The internal iliac artery is identified by locating the bifurcation of the common iliac artery with the ureter crossing it. The external iliac artery is the lateral branch of the common iliac artery and it runs a straight course to continue as the femoral artery in the lower limb. The ureter is identified by peristalsis, and the internal iliac artery is the short medial branch of the common iliac which runs a short course and immediately divides into an anterior and a posterior division, which in turn divide into a number of branches. The uterine artery is the branch of anterior division of the internal iliac artery. The internal iliac artery is ligated by passing a stout suture material under it with the help of a right-angled forceps, or it can be directly occluded with clips, applied using a clip applicator. Conclusion Both the approaches are equally effective and easy to perform. Approaching the internal iliac artery through the round ligament is easier in gynecological surgeries, whereas the pouch of Douglas approach is easier during cesarean section. Clinical significance Internal iliac artery ligation is almost always performed as an emergency, though the need to perform it can be anticipated in advance and the gynecologist can be prepared for it. It is essential for gynecologists to be conversant with this life and a uterus-saving procedure. There are two approaches of doing this procedure and the choice is entirely on the individual. It may not be possible to approach the pouch of Douglas when there are dense adhesions as in case of a frozen pelvis. And it may be time-consuming to approach the internal iliac artery by dividing the round ligaments when there is postpartum hemorrhage. Therefore, it is useful to know both the approaches, because one might encounter a situation where one may find it difficult to follow the technique one is familiar with. How to cite this article Podder AR, Jyothi GS. Internal Iliac Artery Ligation: A Retrospective Analysis of Two Different Approaches. J South Asian Feder Obst Gynae 2017;9(3):230-234.

Internal iliac artery ligation—a contemporary simplified approach

2021 ◽  
Author(s):  
Ari P. Sanders ◽  
Sebastian R. Hobson ◽  
Anna Kobylianskii ◽  
Jessica Papillon Smith ◽  
Lisa Allen ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Artery Ligation ◽  
Simplified Approach ◽  
Internal Iliac Artery Ligation ◽  
Internal Iliac

PROPHYLACTIC BILATERAL INTERNAL ILIAC ARTERY LIGATION, IN PREVENTION OF PPH, IN A CASE OF MULTIPLE LARGE INTRA MURAL FIBROIDS

2021 ◽  
pp. 83-84
Author(s):  
Aditi Gaiwal ◽  
Devdatta Dabholkar
Keyword(s):  
Blood Loss ◽  
Clinical Diagnosis ◽  
Iliac Artery ◽  
Postpartum Haemorrhage ◽  
Internal Iliac Artery ◽  
Artery Ligation ◽  
Internal Iliac Artery Ligation ◽  
Internal Iliac ◽  
Excessive Blood Loss

Postpartum haemorrhage is dened as a blood loss of more than 500ml after delivery of the placenta. It is a clinical diagnosis that encompasses excessive blood loss after delivery of the baby from a variety of sites: uterus, cervix, 1 vagina and perineum

Isolated internal iliac artery infected pseudoaneurysm occlusion using endovascular coil embolisation

2021 ◽  
Vol 14 (6) ◽  
pp. e239005
Author(s):  
Gorrepati Rohith ◽  
Bachavarahalli Sriramareddy Rajesh ◽  
KM Abdulbasith ◽  
Sathasivam Sureshkumar
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Coil Embolisation ◽  
Incision And Drainage ◽  
Wound Debridement ◽  
Anterior Branch ◽  
Ct Angiogram ◽  
Internal Iliac ◽  
Infected Pseudoaneurysm ◽  
The Right

A 34-year-old man presented with painful swelling in the right gluteal region. The MRI showed right sacroiliitis and adjacent intramuscular abscess. The abscess was drained by a pigtail insertion followed by incision and drainage. The patient developed persistent bleeding from the drainage site. CT angiogram revealed a large pear-shaped pseudoaneurysm arising from the anterior branch of the right internal iliac artery. The patient had Abrus precatorius poisoning previously resulting in methicillin-resistant Staphylococcus aureus septicaemia, which incited above events. Digital subtraction angiography with coil embolisation of the right internal iliac artery was done under the cover of culture-specific antibiotics along with thorough wound debridement following which the patient’s condition improved. Isolated infected pseudoaneurysms of internal iliac arteries, although rare, should be considered in cases of complicated sacroiliitis. Under antibiotic cover, endovascular coil embolisation can be considered as a treatment strategy to treat complicated infected pseudoaneurysms located in difficult anatomical locations.

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