Acute bilateral iliac artery occlusion secondary to blunt trauma: Successful endovascular treatment

Sternbergh, W. C., Conners, M. S. and Money, S. R. (2003) Acute bilateral iliac artery occlusion secondary to blunt trauma: Successful endovascular treatment. Journal of Vascular Surgery, 38 3: 589-592.


Author Sternbergh, W. C.
Conners, M. S.
Money, S. R.
Title Acute bilateral iliac artery occlusion secondary to blunt trauma: Successful endovascular treatment
Journal name Journal of Vascular Surgery   Check publisher's open access policy
ISSN 0741-5214; 741-5214
Publication date 2003-09
Sub-type Article (original research)
DOI 10.1016/S0741-5214(03)00295-7
Volume 38
Issue 3
Start page 589
End page 592
Total pages 4
Place of publication Philadelphia, PA, United States
Publisher Mosby
Language eng
Formatted abstract Presentation: A 27-year-old man was crushed between a fork-lift truck and a concrete platform. The physical examination was remarkable for hemodynamic stability, significant lower abdominal ecchymosis and tenderness, obvious pelvic fracture, and gross hematuria. Vascular examination revealed no femoral pulses, no pedal signals bilaterally, and minimal left leg and no right leg motor function. Arteriograms revealed right common iliac artery and external iliac artery occlusion and a 2-cm near occlusion of the left external iliac artery.

Treatment: In the operating room, bilateral common femoral artery access was obtained, and retrograde arteriogram on the right side demonstrated free extravasation of contrast material at the level of the proximal external iliac artery. An angled glide wire was successfully traversed over the vascular injury, and two covered stents (Wallgraft, 10 x 50 turn and 8 x 30 mm) were deployed. The left iliac injury was similarly treated with an 8 x 30-mm, covered stent. After calf fasciotomy, exploratory laparotomy revealed a severe sigmoid colon degloving injury, requiring resection and colostomy. A suprapubic catheter was placed because of bladder rupture, and an open-book pelvic fracture was treated with external fixation. Postoperatively the patient regained palpable bilateral pedal pulses and normal left leg function, but right leg paralysis persisted secondary to severe lumbar plexus nerve injury.

Conclusion: Endovascular repair of blunt intra-abdominal arterial injuries is possible and should be particularly considered when fecal contamination, pelvic hematoma, or multiple associated injuries make conventional repair problematic.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Mon, 14 Mar 2011, 10:04:14 EST