scholarly journals A successful hybrid operation for life-threatening hemorrhagic shock secondary to an iatrogenic ruptured pseudoaneurysm of the external iliac artery following percutaneous arterial access

2018 ◽  
Vol 14 (3) ◽  
Author(s):  
Takahiro Shoji ◽  
Hirohisa Harada ◽  
Shinji Yamazoe ◽  
Yoshihiro Yamaguchi
Keyword(s):  
Renal Artery ◽  
Iliac Artery ◽  
Arterial Embolization ◽  
External Iliac Artery ◽  
Vascular Trauma ◽  
Balloon Occlusion ◽  
Arterial Access ◽  
Iatrogenic Complications ◽  
Life Threatening ◽  
Endovascular Balloon Occlusion

Intravascular treatments such as arterial embolization and resuscitative endovascular balloon occlusion of the aorta are being increasingly performed in emergency cases, in addition to the increasing use of arterial access as an intensive care monitoring tool. Thus, arterial access-related complications are being commonly reported. A 40- year-old man with renal artery stenosis underwent renal artery stent placement via the left inguinal puncture approach. After the procedure, his groin was manually compressed to hemostasis for 30 min. He unexpectedly developed shock the following day, and computed tomography revealed a ruptured pseudoaneurysm of the left external iliac artery (EIA) following iatrogenic vascular trauma owing to an inappropriately performed groin puncture. We initially controlled the hemorrhage using endovascular balloon occlusion of the left EIA. Subsequently, the injured EIA was repaired using a direct suture. The postoperative course was uneventful. Herein, we evaluated the causes of iatrogenic complications and the effectiveness of our treatment strategy.

Successful Control of Massive Vaginal Bleeding with Resuscitative Endovascular Balloon Occlusion of the Aorta and Pelvic Packing

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Emre Özlüer ◽  
Çagaç Yetis ◽  
Evrim Sayin ◽  
Mücahit Avcil
Keyword(s):  
Vaginal Bleeding ◽  
Balloon Occlusion ◽  
Emergency Physicians ◽  
Pelvic Packing ◽  
Gynecological Malignancies ◽  
Life Threatening ◽  
Successful Control ◽  
Endovascular Balloon Occlusion

Gynecological malignancies may present as life-threatening vaginal bleeding. Pelvic packing and Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) may be useful along with conventional vaginal packing when in terms of control of the hemorrhage. Emergency physicians should be able to perform these interventions promptly in order to save their patients from exsanguination.

scholarly journals Increased crystalloid fluid requirements during zone 3 Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) versus Abdominal Aortic and Junctional Tourniquet (AAJT) after class II hemorrhage in swine

2021 ◽  
Author(s):  
Andreas Brännström ◽  
Albin Dahlquist ◽  
Jenny Gustavsson ◽  
Ulf P. Arborelius ◽  
Mattias Günther
Keyword(s):  
Fluid Management ◽  
Class Ii ◽  
Balloon Occlusion ◽  
Metabolic Effects ◽  
Total Blood ◽  
Crystalloid Fluid ◽  
Vasopressor Support ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
Endovascular Balloon Occlusion

Abstract Purpose Pelvic and lower junctional hemorrhage result in a significant amount of trauma related deaths in military and rural civilian environments. The Abdominal Aortic and Junctional Tourniquet (AAJT) and infra-renal (zone 3) Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) are two options for resuscitation of patients with life threatening blood loss from and distal to the pelvis. Evidence suggest differences in the hemodynamic response between AAJT and zone 3 REBOA, but fluid management during resuscitation with the devices has not been fully elucidated. We compared crystalloid fluid requirements (Ringer’s acetate) between these devices to maintain a carotid mean arterial pressure (MAP) > 60 mmHg. Methods 60 kg anesthetized and mechanically ventilated male pigs were subjected to a mean 1030 (range 900–1246) mL (25% of estimated total blood volume, class II) haemorrhage. AAJT (n = 6) or zone 3 REBOA (n = 6) were then applied for 240 min. Crystalloid fluids were administered to maintain carotid MAP. The animals were monitored for 30 min after reperfusion. Results Cumulative resuscitative fluid requirements increased 7.2 times (mean difference 2079 mL; 95% CI 627–3530 mL) in zone 3 REBOA (mean 2412; range 800–4871 mL) compared to AAJT (mean 333; range 0–1000 mL) to maintain target carotid MAP. Release of the AAJT required vasopressor support with norepinephrine infusion for a mean 9.6 min (0.1 µg/kg/min), while REBOA release required no vasopressor support. Conclusion Zone 3 REBOA required 7.2 times more crystalloids to maintain the targeted MAP. The AAJT may therefore be considered in a situation of hemorrhagic shock to limit the need for crystalloid infusions, although removal of the AAJT caused more severe hemodynamic and metabolic effects which required vasopressor support.

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.

Sequential anastomosis of accessory renal artery to external iliac artery in the management of renal transplantation with multiple arteries

2003 ◽  
Vol 35 (1) ◽  
pp. 329-331 ◽  
Author(s):  
H.R Davari ◽  
S.A Malek-Hossini ◽  
H Salahi ◽  
A Bahador ◽  
G.A Rais-Jalali ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Renal Artery ◽  
Iliac Artery ◽  
External Iliac Artery ◽  
Accessory Renal Artery

scholarly journals Successful Surgery of Right Common Iliac Artery Injury during Lumbar Discectomy with Endovascular Balloon Occlusion of the Aorta Performed by Cardiologists

2019 ◽  
Vol 12 (1) ◽  
pp. 60-62 ◽  
Author(s):  
Noriyuki Takashima ◽  
Junghun Lee ◽  
Naoshi Minamidate ◽  
Takanari Fujita ◽  
Masayuki Yamaji ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Common Iliac Artery ◽  
Balloon Occlusion ◽  
Lumbar Discectomy ◽  
Artery Injury ◽  
Endovascular Balloon Occlusion

Retrospective evaluation of the endovascular repair of the anastomotic pseudoaneurysm of the transplanted renal artery using the snorkel technique

Vascular ◽  
2020 ◽  
Vol 28 (4) ◽  
pp. 475-480
Author(s):  
Che Haijie ◽  
Song Fubo ◽  
Li Xiaoying ◽  
Yu Ying ◽  
Pu Zenghui
Keyword(s):  
Renal Artery ◽  
Endovascular Treatment ◽  
Stent Thrombosis ◽  
Iliac Artery ◽  
Endovascular Repair ◽  
External Iliac Artery ◽  
Covered Stent ◽  
Retrospective Evaluation ◽  
Feasible Method ◽  
Anastomotic Pseudoaneurysm

Objective To evaluate the endovascular repair of the transplanted renal artery anastomotic pseudoaneurysm using the snorkel technique. Methods From April 2012 to December 2017, we performed endovascular repair in six patients, who were diagnosed with transplanted renal artery anastomotic pseudoaneurysm, using the snorkel technique. The “snorkel” stent and the “parallel” stent were placed in the transplanted kidney and the external iliac artery, respectively. Another covered stent was implanted at the proximal end of the external iliac artery to match the diameter of the iliac artery. Result and conclusion: Of the six patients, three patients recovered. Two patients experienced pseudoaneurysm rupture due to infection, and one patient developed stent thrombosis; all three patients underwent graft nephrectomy. The endovascular treatment of transplanted renal artery anastomotic pseudoaneurysm with the snorkel technique is a feasible method but needs to comply with certain indications.

scholarly journals Life threatening external iliac artery injury following total hip replacement

2002 ◽  
Vol 49 (3) ◽  
pp. 323-324 ◽  
Author(s):  
Mahesh Kumar Arora ◽  
Anuj Bhatia ◽  
Ganga Prasad ◽  
M. S. Subramanyam
Keyword(s):  
Total Hip Replacement ◽  
Iliac Artery ◽  
Hip Replacement ◽  
External Iliac Artery ◽  
Total Hip ◽  
Artery Injury ◽  
Life Threatening
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