Femoral-Femoral Bypass for Limb Salvage to Correct Common Iliac Occlusion after Lower Extremity Trauma

Background Roadway injuries are a leading cause of lower extremity vascular trauma. Treating these injuries involves controlling life-threatening hemorrhage and restoring distal perfusion. Materials and Methods We describe a unique presentation of chronic iliac artery occlusion in the setting of blunt trauma requiring extra-anatomic bypass for maximal limb salvage. Results A 50-year-old male presented after a pedestrian versus auto accident. He had mangled bilateral lower extremities and was taken emergently for lower extremity amputations. He was found to have chronic left common iliac occlusion and a femoral-femoral bypass was performed to assist with healing his left below-the-knee amputation Discussion Lack of adequate perfusion can cause poor outcomes in limb salvage. This case demonstrated that lower extremity trauma can be complicated by chronic vascular disease. Reperfusion and adequate wound healing can be accomplished by using bypass grafting after more traditional reperfusion techniques fail.

Treatment of Aortic and Iliac Artery Occlusion by Catheter Thrombolysis Combined with Catheter Thrombectomy and Aortic Bifurcation Endovascular Stent Reconstruction

Aortoiliac occlusive disease (AIOD) is an occlusive disease of the infrarenal aorta and iliac arteries usually caused by stenosis or occlusion at the end of the abdominal aorta-common iliac artery. Herein, we reported a case of Trans-Atlantic Inter-Society Consensus- (TASC-) D AIOD with pale, cool, and intangible dorsalis pedis artery treated with catheter thrombolysis combined with catheter thrombectomy and aortic bifurcation endovascular stent reconstruction, which proved to be safe, effective, and minimally invasive approach. In the present paper, we discussed the physical and imaging manifestations, as well as treatments.

A feasible alternative to transfemoral artery access for endovascular revascularization in acute ischemic stroke in cases with difficult vessel anatomy

Endovascular treatment in acute ischemic stroke is usually performed via a transfemoral approach. Catheterization can be problematic in cases with difficult anatomy: unfavorable arch type, vessel tortuosity and ostial stenosis, aorta coarc‑ tation, iliac artery occlusion. The aim of this review is to describe the place of another arterial approach in the manage‑ ment in acute ischemic stroke: direct common carotid

Acute External Iliac Artery Occlusion as an Uncommon Complication Encountered during Coronary Angiography

The article's abstract is not available.

Successfully superior mesenteric artery stenting in operated type A aortic dissection complicated with delayed mesenteric malperfusion

Here, we describe a case of a 61-year-old male patient with acute type A aortic dissection involving the ascending aorta, aortic arch, descending aorta, and the abdominal aorta down to the iliac bifurcation with evidence of left common iliac artery occlusion. Computed tomography angiography revealed progressive dissection into the superior mesenteric artery and left renal artery with no clinical signs of mesenteric ischemia. Emergent ascending aortic reconstruction of the dissected aorta relieves the leg ischemia. On a postoperative day 9, the evolution was complicated by massive right hemothorax. Although the patient was hemodynamically stable after obtaining hemostasis, the patient developed paralytic ileus with a high elevated lactate level. Visceral malperfusion was not detected by exploratory laparotomy. Emergency abdominal aortic angiography revealed superior mesenteric artery intermittent occlusion, successfully treated by stenting implantation.

Radiologic Intervention of Internal Iliac Artery Occlusion During Cesarean Section for Dangerous Placenta Previa

Objective: The cesarean section of dangerous placenta previa always faces the problem of massive hemorrhage. The aim of this study was to analyze the clinical effect of internal iliac artery occlusion combined with obstetric autotransfusion in cesarean section of dangerous placenta previa. Method: From November 2017 to November 2019, 20 patients with placenta previa undergoing cesarean section in our hospital were selected. According to the preoperative MRI and ultrasound diagnosis, the amount of bleeding was evaluated and divided into observation group (n = 6) and control group (n = 14). All patients underwent routine cesarean section and prepared the obstetric autotransfusion device. In the observation group, the internal iliac artery balloon was placed under DSA before operation. After the fetus was taken out, the internal iliac artery was blocked. The internal iliac artery occlusion was not needed in the control group. The total length of stay, Apgar score, the incidence of disseminated intravascular coagulation (DIC), hemorrhagic shock, postoperative infection and renal dysfunction were compared between the two groups. Result: Compared with the relative data in control group, the operation time and postoperative hospital stay of the observation group were significantly shorter, the intraoperative blood loss and blood transfusion were significantly lesser, and the hemoglobin difference before and after operation was significantly lesser. There was no significant difference in the incidence of DIC, hemorrhagic shock, postoperative infection and renal dysfunction between two groups; There was no significant difference in neonatal body mass, Apgar score at 1 min and 5 min. Conclusion: The internal iliac artery occlusion can effectively reduce the amount of bleeding in delivery, promote the recovery of negligence, and have no adverse effect on complications and neonatal outcome.

Common and external iliac artery occlusion in Behçet’s disease: a case of anchoring bias

This report describes the case of a 45-year-old woman with a history of Behçet’s disease and complex regional pain syndrome of her legs who presented with severe pain and swelling in her left lower extremity. The patient was initially diagnosed with exacerbation of complex regional pain syndrome, which fit the symptom complex of hyperalgesia, oedema and skin temperature changes. However, after unsuccessful attempts at significant pain relief during admission, CT angiography demonstrated occlusion of the left common and external iliac arteries, a limb-threatening emergency. This case describes an example of anchoring bias, a type of cognitive bias in which there is a tendency to rely too heavily on an initial piece of information, the ‘anchor’, when making decisions. This report emphasises that clinicians should be aware of biases when making decisions and avoid anchoring bias by asking themselves if their diagnosis is influenced by any leading pieces of information.

Radiologic Intervention of Internal Iliac Artery Occlusion During Cesarean Section for Dangerous Placenta Previa

Objective: The cesarean section of dangerous placenta previa always faces the problem of massive hemorrhage. The aim of this study was to analyze the clinical effect of internal iliac artery occlusion combined with obstetric autotransfusion in cesarean section of dangerous placenta previa. Method: From November 2017 to November 2019, 20 patients with placenta previa undergoing cesarean section in our hospital were selected. According to the preoperative MRI and ultrasound diagnosis, the amount of bleeding was evaluated and divided into observation group (n = 6) and control group (n = 14). All patients underwent routine cesarean section and prepared the obstetric autotransfusion device. In the observation group, the internal iliac artery balloon was placed under DSA before operation. After the fetus was taken out, the internal iliac artery was blocked. The internal iliac artery occlusion was not needed in the control group. The total length of stay, Apgar score, the incidence of disseminated intravascular coagulation (DIC), hemorrhagic shock, postoperative infection and renal dysfunction were compared between the two groups. Result: Compared with the relative data in control group, the operation time and postoperative hospital stay of the observation group were significantly shorter, the intraoperative blood loss and blood transfusion were significantly lesser, and the hemoglobin difference before and after operation was significantly lesser. There was no significant difference in the incidence of DIC, hemorrhagic shock, postoperative infection and renal dysfunction between two groups; There was no significant difference in neonatal body mass, Apgar score at 1 min and 5 min. Conclusion: The internal iliac artery occlusion can effectively reduce the amount of bleeding in delivery, promote the recovery of negligence, and have no adverse effect on complications and neonatal outcome.