Endovascular management of iliac vessel injury during revision of total hip replacement

• Published in: European journal of orthopaedic surgery & traumatology Vol. 17; no. 3; pp. 305 - 309
• Main Authors: Tomé Bermejo, Félix, Pajares Cabanillas, Samuel, Bonilla Madiedo, Luis, Doblas Dominguez, Manuel, Flores Herrero, Ángel, Criado, Enrique
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer Nature B.V 01.05.2007
• Subjects: Injuries; Joint surgery
• DOI: 10.1007/s00590-006-0161-5
• ISSN: 1633-8065

Re-operative hip arthroplasty may be associated with life threatening vascular complications involving the iliac arteries and veins. The anatomic distortion and difficult surgical dissection in a re-operative field often contributes to iliac vascular injuries. Bleeding during removal of the acetabular component of the hip prosthesis is often the initial sign of a major intra-operative vascular injury, the external iliac artery being the most common injured vessel. Preoperative identification of patients at risk for vascular injury during revision of hip arthroplasty is currently feasible and advisable with the information provided by plain X-ray films, angiography, CT-scan and nowadays with the 3D-angio-CT. The traditional approach for intra-operative exposure, control and repair of iliac vascular injuries during re-operative hip arthroplasty has been a retroperitoneal abdomino-pelvic incision. We here present an endovascular approach for the pre-emptive percutaneous control and potential repair of vascular injuries during a second hip arthroplasty revision in a patient at high risk for recurrent bleeding following severe hemorrhage during the initial hip revision.