scholarly journals Transcatheter Artery Embolization for Postoperative Haemorrhage after Arterio-Venous Malformation – Safer Option

2021 ◽  
Vol 28 (1) ◽  
pp. 11
Author(s):  
Panda Subrat ◽  
Sharma Nalini ◽  
Khan Dina Aisha ◽  
Saha Anusmita ◽  
Das Rituparna ◽  
...  
Keyword(s):  
Internal Iliac Artery ◽  
Venous Malformation ◽  
Postoperative Bleeding ◽  
Artery Embolization ◽  
Iliac Arteries ◽  
Postoperative Haemorrhage ◽  
Internal Iliac ◽  
Av Malformation ◽  
Arterio Venous Malformation ◽  
The Right

Introduction: Hemorrhage is one of the commonest and dreaded complications especially with pelvic surgeries. Gestational trophoblastic neoplasias (GTN) are notorious for their propensity to bleed torrentially and metastasis to vital organs. GTN is associated with an arterio-venous malformation (AVM) about 10-15% of the time, which can lead to bleeding after surgery or after complete remission. After the failure of conventional management with chemotherapy or surgery one is compelled to take another modality of management. One of such methods is the use of transcatheter artery embolization in cases of GTN or post-hysterectomy cases of GTN. Transcatheter artery embolization (TAE) was effective in controlling bleeding due to arterio-venous malformation in 96% of cases.Case: 46 years P2L2A5 (para 2, living issue 2, abortion 5) post-hysterectomy patient presented with bleeding from the vagina after surgery. Twice she underwent vaginal vault repair after hysterectomy but failed. Ultrasonography (USG) showed arterio-venous malformation (AVM); angiography revealed massive extravasation from (left internal iliac artery and abnormal vascularity from the right internal iliac. She was taken up for bilateral internal iliac arteries embolization but again had a heavy bout of bleeding after one week. CT scan confirmed a residual lesion and she underwent a repeat embolization after which the bleeding stopped. Serum BHCG was advised during workup and it was 1997 IU/ml. A diagnosis of GTN was confirmed. The patient was discharged after two cycles of chemotherapy with advice to review for the third one on an outpatient department basis.Conclusion: We concluded that TAE is an effective and safer alternative to surgery in postoperative bleeding from AV malformation in the case of GTN. It can be repeated and should be made to more liberal use in emergency settings.

scholarly journals Morphological considerations on the origin and morphometry of the internal iliac arteries

2014 ◽  
Vol 20 (4) ◽  
pp. 219-227
Author(s):  
Oana Popa ◽  
P. Bordei ◽  
D. Iliescu ◽  
C. Ionescu
Keyword(s):  
Intervertebral Disc ◽  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Single Case ◽  
Front Face ◽  
Iliac Arteries ◽  
Internal Iliac ◽  
The Right ◽  
Different Levels ◽  
Internal Iliac Arteries

Abstract The origin of the internal iliac artery, right and left, was studied in 76 cases, 58 cases of male (76.32% of all cases) and 18 female cases (23.68% of all cases). The origin of the internal iliac arteries was considered in relation to the spine (lumbar-sacral). The right internal iliac artery males originates in a range from the upper edge of L4 vertebra - the lower part of fin sacral. It is found that in males, in most cases, 43 cases (74.14% of male cases), right internal iliac artery originates at different levels of sacral fin. We considered that the right iliac artery low origin only the cases in the lower part of the fin sacral, 10 cases (17.24% of male cases). Cases of high origin of the artery, above the fin sacral we found it in 15 cases (25.86% of male cases). From high origins, in the upper edge of the L4 vertebra and intervertebral disc at L4-L5, I met only one single case. Right internal iliac artery in females originated in a range between the upper edges of L5 - the lower part of sacral fin. In females, the right internal iliac artery origin, is located within narrower than in men, but in women, most frequently, 14 cases (77.78% of female the cases) was the origin of the internal iliac located at different levels of sacral fin. The females have not met internal iliac origin above the L5 vertebra or intervertebral disc level L4-L5. High origin was met it in 4 cases (22.22% of female the cases) and low origin in 6 cases (33.33% of female the cases). The level of the left internal iliac artery origin we studied 78 cases, finding it in the same range as in males, i.e., the upper edge of L4 vertebra - the front of the sacrum. In males, on a number of 57 cases (73.08% of all cases) the origin of the left internal iliac artery was made between the upper edge of the vertebra L4 - the front face of the sacrum, most commonly, in 44 cases (77 19% of male the cases) located in the sacral fin. The artery high origin I found it in 9 cases (15.79% of male the cases) and low origin in 18 cases (31.58% of male the cases). I have not met artery origin at L5-S1 intervertebral disc. In terms of low origin, only in males, the left internal iliac artery originated from the anterior to the sacrum, something not found the right internal iliac artery. In females, the 18 cases followed, had their origins in the range lower half of the L5 - middle sacral fin, 17 cases (94.44% of female the cases), terminating at the sacral fin. It is found that in women the origin of the left internal iliac artery is within narrower than the other cases described so far, showing the highest level of origin, this artery in females do not possess low origin. The high origin is present in a small percentage, only 5.56% of cases, encountering any case the origin of the left internal iliac artery is located at the L4 vertebra or the intervertebral discs at L4-L5 or L5-S1. Internal iliac artery diameter was followed on 90 cases, 44 cases for the right internal iliac artery and 46 cases for left internal iliac artery. In males, the right internal iliac artery I found a caliber between 3 to 9.8 mm. In women the right internal iliac artery caliber found between 3.9 to 6.9 mm.

scholarly journals Endovascular therapeutic options for the treatment of aortoiliac aneurysms

2016 ◽  
Vol 43 (6) ◽  
pp. 480-485 ◽  
Author(s):  
BERNARDO MASSIÈRE ◽  
ARNO VON-RISTOW ◽  
ALBERTO VESCOVI ◽  
DANIEL LEAL ◽  
LEA MIRIAN BARBOSA FONSECA
Keyword(s):  
Endovascular Treatment ◽  
Internal Iliac Artery ◽  
Aortic Aneurysms ◽  
Colonic Ischemia ◽  
Artery Embolization ◽  
Iliac Arteries ◽  
Abdominal Aortic ◽  
Internal Iliac ◽  
Ischemic Complications ◽  
Internal Iliac Artery Embolization

ABSTRACT About 20% of patients with abdominal aortic aneurysms have associated iliac aneurysms. Distal sealing during the endovascular treatment of aortic-iliac aneurysms is a challenge that has led to the emergence of several technical options to achieve this goal over the years. Internal iliac artery embolization is associated with the risk of ischemic complications, such as gluteal necrosis, lower limb neurological deficit, colonic ischemia, impotence and gluteal claudication. This article summarizes the technical options for endovascular treatment of aortoiliac aneurysms with different approaches to preserving the patency of internal iliac arteries.

Novel Endovascular Approach Using the Gore Iliac Branch Endograft for Short Iliac Anatomy

2017 ◽  
Vol 25 (1) ◽  
pp. 28-30 ◽  
Author(s):  
Kejia Wang ◽  
Laura Dunkley ◽  
Michael Neale
Keyword(s):  
Aortic Aneurysm ◽  
Internal Iliac Artery ◽  
Iliac Arteries ◽  
Infrarenal Aortic Aneurysm ◽  
Landing Zone ◽  
Internal Iliac ◽  
Endovascular Approach ◽  
The Right ◽  
Common Iliac Arteries

Purpose: To report the use of a branched iliac endograft to maintain internal iliac artery (IIA) patency in a patient with an infrarenal aortic aneurysm and short common iliac arteries (CIA). Case Report: A 74-year-old man presented with an asymptomatic, fusiform, 67-mm infrarenal aortic aneurysm confirmed on computed tomography. The right CIA was funnel shaped and only 15 mm in length, providing no appropriate stent-graft landing zone. The left CIA measured 14 mm in diameter and 25 mm in length. Endovascular repair of the aneurysm with preservation of the IIAs was achieved using a Gore Iliac Branch Endoprosthesis for the short right CIA and a conventional limb to land in the left CIA. Follow-up scans to 24 months have shown continued patency of the IIA and no evidence of endoleak. Conclusion: The Gore Iliac Branch Endograft can be used to successfully treat patients with short CIA anatomy while preserving flow to the ipsilateral IIA, with maintained early patency of the IIA limb.

Internal Iliac Artery Embolization Before Endovascular Repair of Abdominal Aortic Aneurysms

2001 ◽  
Vol 177 (3) ◽  
pp. 599-605 ◽  
Author(s):  
Maria Schoder ◽  
Luise Zaunbauer ◽  
Thomas Hölzenbein ◽  
Dominik Fleischmann ◽  
Manfred Cejna ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Endovascular Repair ◽  
Internal Iliac Artery ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Artery Embolization ◽  
Abdominal Aortic ◽  
Internal Iliac ◽  
Internal Iliac Artery Embolization

Effect of Internal Iliac Artery Embolization Combined With Arterial Infusion Chemotherapy On Serum VEGF, HGF and IL-6 in Advanced Cervical Cancer

2021 ◽  
Vol 7 (4) ◽  
pp. 538-545
Author(s):  
Xiaoru Li ◽  
Yan Zhao ◽  
Tao Yu
Keyword(s):  
Cervical Cancer ◽  
Internal Iliac Artery ◽  
Observation Group ◽  
Advanced Cervical Cancer ◽  
Artery Embolization ◽  
Arterial Infusion ◽  
Arterial Infusion Chemotherapy ◽  
Infusion Chemotherapy ◽  
Internal Iliac ◽  
Internal Iliac Artery Embolization

This study aimed to investigate the effect of internal iliac artery embolization combined with arterial infusion chemotherapy on serum VEGF, HGF and IL-6 in advanced cervical cancer. A total of 120 cases of patients with advanced cervical cancer and admitted to Binzhou Center Hospital from January 2014 to March 2016 were selected as research subjects. Among them, 59 patients received arterial infusion chemotherapy were enrolled in the control group, and 61 patients received arterial infusion chemotherapy combined with internal iliac artery embolization were included in the observation group. Treatment efficacy, serum VEGF, HGF and IL-6 expression, KPS score and QOL score, incidence of adverse reactions and 3-year survival rate of the two groups were recorded and compared. The result showed that the therapeutic effect of the observation group was significantly higher than that of the control group (P<0.05). The expression of serum VEGF, HGF and IL-6, KPS score and QOL score in the two groups were significantly improved after treatment, with more significant improvement in the observation group (P<0.05). There were no significant differences in the incidence of adverse reactions between the two groups (P>0.05). And the 3-year survival rate of the observation group was significantly higher than that of the control group (P<0.05). In conclusion, arterial infusion chemotherapy combined with internal iliac artery embolization has a better effect than arterial infusion chemotherapy alone in treating patients with advanced cervical cancer. It can effectively prolong the survival of patients, along with good safety, which is worthy of clinical promotion

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.

scholarly journals Role of bilateral internal iliac artery ligation in severe obstetric and gynaecological hemorrhage

2018 ◽  
Vol 7 (3) ◽  
pp. 1090 ◽  
Author(s):  
Shashi Lata Kabra Maheshwari ◽  
Nisha Kumari ◽  
Syed N. Ahmad
Keyword(s):  
Success Rate ◽  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Care Hospital ◽  
Artery Ligation ◽  
Iliac Arteries ◽  
Internal Iliac Artery Ligation ◽  
Internal Iliac ◽  
Internal Iliac Arteries

Background: Massive pelvic haemorrhage is a potentially lethal complication while undergoing obstetric and gynaecological surgery. The objective of this study was to study of role of bilateral internal iliac artery ligation in severe obstetric and gynaecological haemorrhage. It was a prospective interventional study carried out in a multi-speciality tertiary care hospital in New Delhi.Methods: Thirty-five patients (31 obstetric and 4 gynaecological) fulfilling the inclusion criteria over a period of 2 years were included in the study cohort after informed consent. After laparotomy, internal iliac arteries were exposed by incising the peritoneal fold between the infundibulo-pelvic and round ligaments. A number 1 silk suture and right-angled artery forceps were used to tie the internal iliac arteries approximately 1 inch below their origin. The success and complications of the procedure were analysed.Results: In the present study 31 out of 35 cases underwent BIIAL for obstetrical cause of haemorrhage and rest 4 for gynaecological cause. In 19 out of 31 patients, hysterectomy preceded or followed BILAL depending upon the clinical situation making a uterine salvation rate of 38.7%. The success rate of BIIAL was 67.7% in 31 obstetric cases. In the 4 gynaecological cases BILAL was done to arrest post-hysterectomy haemorrhage and success rate was 100%. Among 35 patients one patient died of haemorrhagic shock and 4 other died of full blown sepsis and MODS in surgical ICU. No significant procedure related complications were encountered.Conclusions: BILAL is a very effective procedure to control PPH and pelvic haemorrhage due to other causes and helps save the much precious lives and uteri. This procedure can always be tried where procedures like embolization are unavailable.

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