scholarly journals Internal iliac artery transposition for vascular reconstruction in a patient with life-threatening iatrogenic common iliac artery injury

2018 ◽  
pp. bcr-2016-219138 ◽  
Author(s):  
Biplab Mishra ◽  
Mohit Kumar Joshi ◽  
Babita Gupta ◽  
Kamran Farooque
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Common Iliac Artery ◽  
Vascular Reconstruction ◽  
Artery Injury ◽  
Internal Iliac ◽  
Life Threatening

scholarly journals Delayed bleeding after prophylactic bilateral internal iliac artery balloon occlusion in elective caesarean hysterectomy for the management of placenta accreta

2017 ◽  
Vol 6 (4) ◽  
pp. 1656
Author(s):  
Abdul Karim Othman ◽  
Noraslawati Razak ◽  
Mohd Hanif Che Mat
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Placenta Previa ◽  
Balloon Occlusion ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
Internal Iliac ◽  
Life Threatening ◽  
Caesarean Hysterectomy ◽  
Placenta Accrete

Morbidly adherent placenta (MAP) can be divided into placenta accrete, placenta increta and placenta percreta. It is associated with high parity, multifetal gestation, advanced maternal age, assisted reproductive technologies, placenta previa, and more importantly a history of caesarean section or uterine surgery. Globally, the incidence of placenta accrete has increased and seems to be in parallel with the increasing rate of caesarean section delivery.Despite rapidly evolving diagnostic imaging, and growing of surgical expertise, morbidly adherent placenta (MAP) remains an important cause of maternal morbidity and mortality, especially related with life-threatening postpartum haemorrhage. Although the choice of treatment for placenta accrete is puerperal hysterectomy, this procedure itself involves a greater risk of intra-operative haemorrhage.Elective caesarean hysterectomy using prophylactic bilateral internal iliac artery balloon occlusion offer an interesting approach which can minimize the risk of intra-operative haemorrhage. However, our case report describes the case of a 28-year old Gravida 3 Para 2 morbidly obese parturient diagnosed to have placenta previa type 3 posterior with accrete who experienced a complication of life threatening massive bleeding post-operatively after an elective caesarean hysterectomy using a prophylactic bilateral internal iliac artery balloon occlusion intra-operatively.

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.

scholarly journals Bilateral internal iliac artery ligation: the procedure of choice in life threatening postpartum haemorrhage

2020 ◽  
Vol 9 (9) ◽  
pp. 3607
Author(s):  
Sameer P. Darawade ◽  
Arti A. Wagle ◽  
Sneha Trivedi ◽  
Saloni Manwani
Keyword(s):  
Postoperative Complications ◽  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Iliac Vein ◽  
Artery Ligation ◽  
Vein Thrombosis ◽  
Internal Iliac Artery Ligation ◽  
Internal Iliac ◽  
Life Threatening ◽  
Vein Injury

Background: The present study was to assess the indication and study the intraoperative and postoperative complications of bilateral internal iliac artery ligation. Aim of this study was to evaluate the effectiveness of internal iliac artery ligation in arresting postpartum haemorrhage.Methods: This is a retrospective study carried out between January 2015 to December 2018 at Shrimati Kashibai Navale Medical College and General Hospital, Pune. This study included 48 patients with life-threatening PPH. Bilateral internal iliac artery ligation was done by anterior approach in 7 patients and by posterior approach in 41 patients.Results: Intraoperative and postoperative complications were noted in all patients. Of the total patients, 10 required massive blood transfusion and 12 underwent obstetrical hysterectomies (n=12; 25%). Internal iliac vein injury was seen in 1 patient (n=1; 2.08%) and external vein thrombosis was noted in 3 patients (n=3; 6.25%). Maternal mortality was observed in 1 patient due to DIC on day 9 (n=1; 2.08%). The uterine salvage rate was 75%.Conclusions: Internal iliac artery ligation (IIAL) safe, rapid, effective, time tested method of controlling bleeding from genital tract.

Off-label use of a reversed flared endurant iliac limb stengraft for the management of a life-threatening internal iliac artery aneurysm rupture

Vascular ◽  
2014 ◽  
Vol 22 (5) ◽  
pp. 381-384 ◽  
Author(s):  
Gino Gemayel ◽  
Nicolas Murith ◽  
Afksendiyos Kalangos
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Artery Aneurysm ◽  
Emergency Situation ◽  
Aneurysm Rupture ◽  
Off Label Use ◽  
Iliac Artery Aneurysm ◽  
Internal Iliac Artery Aneurysm ◽  
Internal Iliac ◽  
Life Threatening

We report a case of a life-threatening internal iliac artery aneurysm rupture managed successfully with an on-table reversed flared iliac limb stentgraft and embolization. This easily off-the-shelf reproducible technique avoids using a more complex and expensive bifurcated aorto-iliac graft and could be a good solution in emergency situation where a custom graft is not available.

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