Asunto(s)

Arteria Ilíaca , Colgajo Perforante , Procedimientos de Cirugía Plástica , Traumatismos de los Tejidos Blandos , Pulgar , Humanos , Masculino , Colgajo Perforante/irrigación sanguínea , Colgajo Perforante/trasplante , Pulgar/lesiones , Pulgar/cirugía , Adolescente , Procedimientos de Cirugía Plástica/métodos , Arteria Ilíaca/cirugía , Arteria Ilíaca/lesiones , Arteria Ilíaca/trasplante , Traumatismos de los Tejidos Blandos/cirugía , Colgajos Tisulares Libres/trasplante , Colgajos Tisulares Libres/irrigación sanguínea

RESUMEN

Bone marrow biopsy (BMB) is a routinely performed procedure, with the preferred site being the posterior superior iliac crest. Uncommonly, it may be complicated by haemorrhagic complications, especially in patients with coagulopathy. Here, we present a case of pelvic haematoma following a BMB due to the injury of the right internal iliac artery. Endovascular embolisation was performed on an urgent basis to manage this complication. The bleeding stopped following the embolisation.

Asunto(s)

Aneurisma Falso , Embolización Terapéutica , Hematoma , Enfermedad Iatrogénica , Arteria Ilíaca , Humanos , Aneurisma Falso/etiología , Aneurisma Falso/terapia , Aneurisma Falso/diagnóstico por imagen , Embolización Terapéutica/efectos adversos , Hematoma/etiología , Arteria Ilíaca/lesiones , Arteria Ilíaca/diagnóstico por imagen , Biopsia/efectos adversos , Femenino , Procedimientos Endovasculares , Masculino , Médula Ósea/patología , Persona de Mediana Edad

RESUMEN

OBJECTIVE: To evaluate the mid-term outcomes of different treatment strategies for the internal iliac artery (IIA) during EVAR. METHODS: This was a retrospective study. All patients undergoing EVAR, who required treatment of at least one side of IIA from January 2013 to July 2022 in a single center, were included. According to the different treatment strategies for IIA, the patients were divided into UP (unilateral preservation), BP (bilateral preservation) and BE (bilateral embolization) groups. The primary outcomes included buttock claudication, bowel ischemia and iliac-related reintervention. Then patients who underwent IIA reconstruction were divided into IPG (iliac parallel stent graft) and IBG (iliac branch stent graft) groups according to the reconstruction technique. The primary outcomes included endoleak, iliac branch occlusion and iliac-related reintervention. RESULTS: A total of 237 patients were included, including 167 in the UP group, 9 in the BP group and 61 in the BE group. The mean follow-up time was 39.0 ± 27.7, 50.0 ± 22.1 and 25.8 ± 18.9 months in UP, BP and BE groups, respectively. Thirty cases (12.7%) of buttock claudication occurred, and it was significantly higher in the BE group than the UP group (26.2% vs. 7.8%, p < 0.001). There were no significant differences in the other follow-up outcomes among three groups. The K-M analysis indicated that the patients in the BE group had a lower survival rate than those in the other two groups (p = 0.024). 24 patients underwent IIA reconstruction, including 8 in the IPG group and 16 in the IBG group. The endoleak in the IBG group was significantly lower than that in the IPG group (0% vs. 25.0%, p = 0.041). The iliac-related reintervention, iliac occlusion and mortality were similar between the two groups. CONCLUSION: Overall it is beneficial for patients to preserve at least one side of IIA during EVAR as much as possible. Compared with IPG, IBG might be more applicable for IIA reconstruction.

Asunto(s)

Procedimientos Endovasculares , Arteria Ilíaca , Humanos , Procedimientos Endovasculares/métodos , Procedimientos Endovasculares/efectos adversos , Masculino , Femenino , Anciano , Arteria Ilíaca/cirugía , Estudios Retrospectivos , Resultado del Tratamiento , Stents , Implantación de Prótesis Vascular/efectos adversos , Implantación de Prótesis Vascular/métodos , Anciano de 80 o más Años , Aneurisma de la Aorta Abdominal/cirugía , Aneurisma Ilíaco/cirugía , Endofuga/cirugía , Endofuga/etiología , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/epidemiología , Embolización Terapéutica/métodos , Reparación Endovascular de Aneurismas

RESUMEN

While chronic limb-threatening ischemia is a serious peripheral artery disease, the lack of an appropriate stent significantly limits the potential of interventional treatment. In spite of much progress in coronary stents, little is towards peripheral stents, which are expected to be both long and biodegradable and thus require a breakthrough in core techniques. Herein, we develop a long and biodegradable stent with a length of up to 118 mm based on a metal-polymer composite material. To achieve a well-prepared homogeneous coating on a long stent during ultrasonic spraying, a magnetic levitation is employed. In vivo degradation of the stent is investigated in rabbit abdominal aorta/iliac arteries, and its preclinical safety is evaluated in canine infrapopliteal arteries. First-in-man implantation of the stent is carried out in the below-the-knee artery. The 13 months' follow-ups demonstrate the feasibility of the long and biodegradable stent in clinical applications.

Asunto(s)

Implantes Absorbibles , Enfermedad Arterial Periférica , Stents , Animales , Conejos , Perros , Enfermedad Arterial Periférica/terapia , Arteria Ilíaca/cirugía , Aorta Abdominal/cirugía , Polímeros/química , Masculino , Arteria Poplítea/cirugía , Humanos

RESUMEN

RATIONALE: Uterine arteriovenous fistula (UAVF) is a rare vascular abnormality that can cause severe and potentially life-threatening hemorrhage. Uterine artery embolization is a common treatment that may affect ovarian and uterine perfusion and cause fertility problems. We herein report our experience treating 2 patients with UAVF who underwent resection after temporary occlusion of both internal iliac arteries. PATIENT CONCERNS: Both patients presented with a large UAVF after incomplete miscarriages in the second trimester. Magnetic resonance imaging revealed a UAVF measuring 3.6 × 2.6 × 2.1 cm over the myometrium of the posterior uterine in case 1, and a UAVF of 7.1 × 4.1 × 4.5 cm was identified in case 2. DIAGNOSIS: Uterine arteriovenous fistula, retained products of conception. INTERVENTIONS: The patients underwent resection of UAVF with temporary occlusion of the internal iliac arteries and hysteroscopic removal of the retained products of conception. OUTCOMES: Intraoperative bleeding were minimal. Neither patient exhibited abnormal uterine bleeding at the 6-month follow-up. Follow-up ultrasonography and magnetic resonance imaging showed normal uterine myometrium and endometrium and no residual disease. LESSONS: UAVF resection after temporary occlusion of the internal iliac arteries is a promising treatment approach for UAVF. This technique can reduce intraoperative bleeding and remove the potential hemorrhage-related lesion while preserving fertility.

Asunto(s)

Fístula Arteriovenosa , Arteria Ilíaca , Humanos , Femenino , Arteria Ilíaca/cirugía , Arteria Ilíaca/diagnóstico por imagen , Fístula Arteriovenosa/cirugía , Adulto , Arteria Uterina/cirugía , Arteria Uterina/diagnóstico por imagen , Embarazo , Hemorragia Uterina/etiología , Hemorragia Uterina/cirugía , Embolización de la Arteria Uterina/métodos , Imagen por Resonancia Magnética , Útero/irrigación sanguínea , Útero/cirugía

RESUMEN

The internal iliac artery arises as a terminal extension of the common iliac artery and supplies blood to the pelvic region. This study aims to identify the anatomic variations of the internal iliac artery (IIA) in a Mexican population sample. This is a retrospective cross-sectional observational study. A total of 81 angiographies via the femoral artery approach performed on patients undergoing various medical procedures were included. Variations in the IIA branching patterns were identified by evaluating the angiographic images and grouped according to Adachi's classification into five types (I-V). A total of 139 hemipelvises were analyzed (78 right and 61 left). The frequencies of each type of variation were as follows: Type I (71.2%), Type II (10.79%), Type III (0 cases), Type IV (0.7%), Type V (12.94%), and unclassified (4.31%). The most frequent anatomical variants of the IIA in the western Mexican population sample were Type I, followed by Types V and II. Even though Type V is rare in most populations, it was the second most frequent variant in this study. Understanding the variants of the IIA branching pattern is necessary for performing invasive procedures in the pelvic region with precision and minimizing complications.

Asunto(s)

Variación Anatómica , Arteria Ilíaca , Humanos , México , Arteria Ilíaca/anatomía & histología , Arteria Ilíaca/diagnóstico por imagen , Femenino , Masculino , Persona de Mediana Edad , Estudios Transversales , Estudios Retrospectivos , Prevalencia , Adulto , Anciano , Angiografía , Anciano de 80 o más Años

RESUMEN

BACKGROUND: This study was conducted to evaluate the differences between pre- and postoperative access conditions in percutaneous endovascular aortic repair (PEVAR). METHODS: Between December 2021 and October 2023, PEVAR was performed on 61 patients using the Perclose ProStyle (Abbott Vascular). Enhanced computed tomography and ankle-brachial index tests were performed preoperatively and postoperatively. The inner diameter and area of the iliofemoral artery were automatically measured, and the pre- and postoperative values were compared (114 legs). The same analysis was performed on 12 legs with previous groin operations; open surgical EVAR was performed in 9 legs, an endarterectomy of the femoral artery in 1, and a femoropopliteal bypass in the other leg. RESULTS: All patients were discharged without surgical site infections, lymphatic fistulas, or retroperitoneal haematomas. There were no significant differences between the pre-and postoperative inner diameter and inner area of the external iliac artery and common femoral artery. There were no significant differences between the preoperative and postoperative ankle-brachial index tests. In 12 legs with a previous groin operation, the postoperative ankle-brachial index tests and inner diameter and area of the external iliac artery and common femoral artery were statistically equal to the preoperative values. CONCLUSIONS: This study can support the safety of percutaneous endovascular aortic repair, even in patients with redo groin operations.

Asunto(s)

Índice Tobillo Braquial , Procedimientos Endovasculares , Arteria Femoral , Arteria Ilíaca , Humanos , Arteria Femoral/cirugía , Arteria Femoral/diagnóstico por imagen , Masculino , Procedimientos Endovasculares/métodos , Femenino , Anciano , Arteria Ilíaca/cirugía , Arteria Ilíaca/diagnóstico por imagen , Estudios Prospectivos , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Anciano de 80 o más Años , Aneurisma de la Aorta Abdominal/cirugía , Reparación Endovascular de Aneurismas

RESUMEN

Electromagnetic tracking of endovascular instruments has the potential to substantially decrease radiation exposure of patients and personnel. In this study, we evaluated the in vivo accuracy of a vessel-based method to register preoperative computed tomography angiography (CTA) images to physical coordinates using an electromagnetically tracked guidewire. Centerlines of the aortoiliac arteries were extracted from preoperative CTA acquired from five swine. Intravascular positions were obtained from an electromagnetically tracked guidewire. An iterative-closest-point algorithm registered the position data to the preoperative image centerlines. To evaluate the registration accuracy, a guidewire was placed inside the superior mesenteric, left and right renal arteries under fluoroscopic guidance. Position data was acquired with electromagnetic tracking as the guidewire was pulled into the aorta. The resulting measured positions were compared to the corresponding ostia manually identified in the CTA images after applying the registration. The three-dimensional (3D) Euclidean distances were calculated between each corresponding ostial point, and the root mean square (RMS) was calculated for each registration. The median 3D RMS for all registrations was 4.82 mm, with an interquartile range of 3.53-6.14 mm. A vessel-based registration of CTA images to vascular anatomy is possible with acceptable accuracy and encourages further clinical testing. RELEVANCE STATEMENT: This study shows that the centerline algorithm can be used to register preoperative CTA images to vascular anatomy, with the potential to further reduce ionizing radiation exposure during vascular procedures. KEY POINTS: Preoperative images can be used to guide the procedure without ionizing intraoperative imaging. Preoperative imaging can be the only imaging modality used for guidance of vascular procedures. No need to use external fiducial markers to register/match images and spatial anatomy. Acceptable accuracy can be achieved for navigation in a preclinical setting.

Asunto(s)

Algoritmos , Angiografía por Tomografía Computarizada , Animales , Angiografía por Tomografía Computarizada/métodos , Porcinos , Catéteres , Fenómenos Electromagnéticos , Arteria Ilíaca/diagnóstico por imagen , Arteria Ilíaca/anatomía & histología , Arteria Renal/diagnóstico por imagen , Arteria Renal/anatomía & histología

RESUMEN

BACKGROUND: The introduction of radial-specific equipment has made transradial (TR) aortoiliac (AI) endovascular therapy (EVT) more convenient. OBJECTIVES: The authors aimed to investigate the perioperative outcomes of the TR approach in patients undergoing AI EVT for symptomatic peripheral artery disease. METHODS: The COMFORT (Contemporary Strategy for Aortoiliac Intervention) registry was a prospective, multicenter, observational study enrolling patients with symptomatic peripheral artery disease undergoing AI EVT between January 2021 and June 2023. The primary outcome was perioperative complications, whereas the secondary outcomes included core laboratory-evaluated residual stenosis >30%, time to hemostasis, time to ambulation, 30-day patency, and 30-day limb symptoms. These outcomes were compared between TR and non-TR AI EVT after propensity score matching. RESULTS: The TR approach was selected for 231 of the 947 patients (24.3%). The TR approach was chosen more in patients with a higher ankle-brachial index, chronic total occlusion, aortic lesion, bare nitinol stent implantation, and plain angioplasty, whereas it was chosen less in patients with dialysis, a history of AI EVT, chronic limb-threatening ischemia, bilateral calcification, and simultaneous infrainguinal EVT (all P < 0.05). After propensity score matching, the incidence of perioperative complications did not differ significantly between the groups (TR group: 6.0% vs non-TR group: 5.1%; P = 0.69). The proportions of residual stenosis, 30-day patency, and 30-day limb symptoms were not significantly different (all P > 0.05); however, the time to hemostasis and the time to ambulation were shorter in the TR group (both P < 0.05). CONCLUSIONS: Non-TR AI EVT and TR AI EVT using radial-specific equipment were associated with a similar risk of perioperative complications. The TR approach helps shorten the time required for hemostasis and ambulation.

Asunto(s)

Procedimientos Endovasculares , Arteria Ilíaca , Enfermedad Arterial Periférica , Arteria Radial , Sistema de Registros , Grado de Desobstrucción Vascular , Humanos , Femenino , Masculino , Anciano , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/instrumentación , Estudios Prospectivos , Arteria Radial/fisiopatología , Resultado del Tratamiento , Factores de Tiempo , Arteria Ilíaca/diagnóstico por imagen , Arteria Ilíaca/fisiopatología , Arteria Ilíaca/cirugía , Persona de Mediana Edad , Enfermedad Arterial Periférica/terapia , Enfermedad Arterial Periférica/fisiopatología , Enfermedad Arterial Periférica/diagnóstico por imagen , Factores de Riesgo , Medición de Riesgo , Anciano de 80 o más Años , Cateterismo Periférico/efectos adversos , Stents , Punciones

Asunto(s)

Cateterismo Periférico , Procedimientos Endovasculares , Arteria Ilíaca , Arteria Radial , Humanos , Arteria Radial/diagnóstico por imagen , Arteria Ilíaca/diagnóstico por imagen , Arteria Ilíaca/fisiopatología , Cateterismo Periférico/efectos adversos , Procedimientos Endovasculares/instrumentación , Resultado del Tratamiento , Punciones , Factores de Riesgo , Enfermedades de la Aorta/diagnóstico por imagen , Enfermedades de la Aorta/terapia , Enfermedades de la Aorta/fisiopatología

RESUMEN

BACKGROUND: Tumorous diseases of the jaw demand effective treatments, often involving continuity resection of the jaw. Reconstruction via microvascular bone flaps, like deep circumflex iliac artery flaps (DCIA), is standard. Computer aided planning (CAD) enhances accuracy in reconstruction using patient-specific CT images to create three-dimensional (3D) models. Data on the accuracy of CAD-planned DCIA flaps is scarce. Moreover, the data on accuracy should be combined with data on the exact positioning of the implants for well-fitting dental prosthetics. This study focuses on CAD-planned DCIA flaps accuracy and proper positioning for prosthetic rehabilitation. METHODS: Patients post-mandible resection with CAD-planned DCIA flap reconstruction were evaluated. Postoperative radiograph-derived 3D models were aligned with 3D models from the CAD plans for osteotomy position, angle, and flap volume comparison. To evaluate the DCIA flap's suitability for prosthetic dental rehabilitation, a plane was created in the support zone and crestal in the middle of the DCIA flap. The lower jaw was rotated to close the mouth and the distance between the two planes was measured. RESULTS: 20 patients (12 males, 8 females) were included. Mean defect size was 73.28 ± 4.87 mm; 11 L defects, 9 LC defects. Planned vs. actual DCIA transplant volume difference was 3.814 ± 3.856 cm³ (p = 0.2223). The deviation from the planned angle was significantly larger at the dorsal osteotomy than at the ventral (p = 0.035). Linear differences between the planned DCIA transplant and the actual DCIA transplant were 1.294 ± 1.197 mm for the ventral osteotomy and 2.680 ± 3.449 mm for the dorsal (p = 0.1078). The difference between the dental axis and the middle of the DCIA transplant ranged from 0.2 mm to 14.8 mm. The mean lateral difference was 2.695 ± 3.667 mm in the region of the first premolar. CONCLUSION: The CAD-planned DCIA flap is a solution for reconstructing the mandible. CAD planning results in an accurate reconstruction enabling dental implant placement and dental prosthetics.

Asunto(s)

Arteria Ilíaca , Colgajos Quirúrgicos , Humanos , Masculino , Femenino , Persona de Mediana Edad , Colgajos Quirúrgicos/irrigación sanguínea , Colgajos Quirúrgicos/trasplante , Arteria Ilíaca/cirugía , Arteria Ilíaca/diagnóstico por imagen , Anciano , Adulto , Cirugía Asistida por Computador/métodos , Imagenología Tridimensional , Procedimientos de Cirugía Plástica/métodos , Neoplasias Mandibulares/cirugía , Estudios Retrospectivos , Reconstrucción Mandibular/métodos , Masticación/fisiología , Resultado del Tratamiento

RESUMEN

OBJECTIVES: To compare the clinical outcomes of anterolateral femoral interregional flap with turbocharge technique and traditional anterolateral femoral flap in repair of large limb wounds. METHODS: Clinical data of 38 patients with large limb surface wound (11 cm×39 cm-16 cm×65 cm) admitted to the Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from May 2018 to May 2022 were retrospectively analyzed. Eighteen patients were treated by anterolateral thigh perforator flap combined with superficial circumflex iliac artery flap (ALTP-SCIAP) with turbocharge technique (interregional flap group); while 20 patients were treated with unilateral or bilateral anterolateral femoral flaps, combined with skin grafting if necessary (traditional anterolateral femoral flap group). The survival of skin flap, repair of donor area, complications and patient satisfaction were compared between the two groups. RESULTS: In interregional flap group, 18 flaps were harvested and transplanted, the flap width, length and the viable area were (9.9±2.0) cm, (44.2±3.5) cm and (343.2±79.9) cm2, respectively. In traditional anterolateral femoral flap group, 29 flaps were harvested and transplanted, the flap width, length and the viable area were (11.0±2.8) cm, (21.7±3.2) cm and (186.4±49.2) cm2, respectively. There were significant differences in the flap length and the viable area between the two groups (t=22.365 and 8.345, both P<0.05). In the interregional flap group, the donor site of flap was closed by direct suture in 11 flaps, by skin retractor assisted suture in 6 flaps, and by skin grafting in one flap. In traditional anterolateral femoral flap group, the donor site of flap was closed by direct suture in 12 flaps, by skin retractor assisted suture in 11 flaps, and by skin grafting in 6 flaps. The skin graft rates of the two groups were 5.6% (1/18) and 20.7% (6/29), respectively (χ2=2.007, P>0.05). The interregional flap group had lower postoperative complications rate (5.6% vs. 35.0%, χ2=4.942, P<0.05) and higher patient satisfaction rate (94.4% vs. 70.0%, χ2=4.448, P<0.05) than traditional anterolateral femoral flap group. CONCLUSIONS: Compared with the traditional anterolateral femoral flap, the anterolateral femoral interregional flap with turbocharge technique has a larger flap area, most of the donor areas of the flap can be sutured directly without skin grafting and with less complications and a higher patient satisfaction rate.

Asunto(s)

Colgajo Perforante , Procedimientos de Cirugía Plástica , Trasplante de Piel , Colgajos Quirúrgicos , Humanos , Estudios Retrospectivos , Trasplante de Piel/métodos , Procedimientos de Cirugía Plástica/métodos , Masculino , Femenino , Satisfacción del Paciente , Fémur/cirugía , Muslo/cirugía , Arteria Ilíaca/cirugía , Cicatrización de Heridas , Persona de Mediana Edad , Adulto

RESUMEN

BACKGROUND: The Global Iliac Branch Study (NCT05607277) is an international, multicenter, retrospective cohort study of anatomic predictors of adverse iliac events (AIEs) in aortoiliac aneurysms treated with iliac branch devices (IBDs). METHODS: Patients with pre-IBD and post-IBD computed tomography imaging were included. We measured arterial diameters, stenosis, calcification, bifurcation angles, and tortuosity indices using a standardized, validated protocol. A composite of ipsilateral AIE was defined, a priori, as occlusion, type I or III endoleak, device constriction, or clinical event requiring reintervention. Paired t-test compared tortuosity indices and splay angles pretreatment and post-treatment for all IBDs and by device material (stainless steel and nitinol). Two-sample t-test compared anatomical changes from pretreatment to post-treatment by device material. Logistic regression assessed associations between AIE and anatomic measurements. Analysis was performed by IBD. RESULTS: We analyzed 297 patients (286 males, 11 females) with 331 IBDs (227 stainless steel, 104 nitinol). Median clinical follow-up was 3.8 years. Iliac anatomy was significantly straightened with all IBD treatment, though stainless steel IBDs had a greater reduction in total iliac artery tortuosity index and aortic splay angle compared to nitinol IBDs (absolute reduction -0.20 [-0.22 to -0.18] vs. -0.09 [-0.12 to -0.06], P < 0.0001 and -19.6° [-22.4° to -16.9°] vs. -11.2° [-15.3° to -7.0°], P = 0.001, respectively). There were 54 AIEs in 44 IBDs in 42 patients (AIE in 13.3% of IBD systems), requiring 35 reinterventions (median time to event 41 days; median time to reintervention 153 days). There were 18 endoleaks, 29 occlusions, and 5 device constrictions. There were no strong associations between anatomic measurements and AIE overall, though internal iliac diameter was inversely associated with AIE in nitinol devices (nAIE, nitinol = 8). CONCLUSIONS: Purpose-built IBDs effectively treat aortoiliac disease, including that with tortuous anatomy, with a high patency rate (91.5%) and low reintervention rate (9.1%) at 4 years. Anatomic predictors of AIE are limited.

Asunto(s)

Aleaciones , Implantación de Prótesis Vascular , Prótesis Vascular , Angiografía por Tomografía Computarizada , Procedimientos Endovasculares , Aneurisma Ilíaco , Valor Predictivo de las Pruebas , Diseño de Prótesis , Stents , Humanos , Femenino , Masculino , Aneurisma Ilíaco/diagnóstico por imagen , Aneurisma Ilíaco/cirugía , Aneurisma Ilíaco/fisiopatología , Estudios Retrospectivos , Procedimientos Endovasculares/instrumentación , Procedimientos Endovasculares/efectos adversos , Anciano , Resultado del Tratamiento , Implantación de Prótesis Vascular/instrumentación , Implantación de Prótesis Vascular/efectos adversos , Factores de Tiempo , Factores de Riesgo , Anciano de 80 o más Años , Persona de Mediana Edad , Aortografía , Acero Inoxidable , Endofuga/etiología , Endofuga/diagnóstico por imagen , Aneurisma de la Aorta/diagnóstico por imagen , Aneurisma de la Aorta/cirugía , Aneurisma de la Aorta/fisiopatología , Arteria Ilíaca/diagnóstico por imagen , Arteria Ilíaca/fisiopatología , Arteria Ilíaca/cirugía , Estados Unidos

RESUMEN

PURPOSE: Internal iliac artery ligation (IIAL) has been used as a damage control procedure to treat hemodynamically unstable pelvic fracture for many years. However, there is ongoing debate regarding the effectiveness and safety of this hemostatic method. Therefore, we performed a systematic literature review to assess the efficacy and safety of IIAL for pelvic fracture hemostasis. METHODS: Three major databases, PubMed, Embase, and Google Scholar, were searched to screen eligible original studies published in English journals. Two reviewers independently read the titles, abstracts, and full texts of all literature. Articles were included if they reported the use and effects of IIAL. RESULTS: A total of 171 articles were initially identified, with 22 fully meeting the inclusion criteria. Among the analyzed cases, up to 66.7% of patients had associated abdominal and pelvic organ injuries, with the urethra being the most frequently injured organ, followed by the bowel. The outcomes of IIAL for achieving hemostasis in pelvic fractures were found to be satisfactory, with an effective rate of 80%. Hemorrhagic shock was the leading cause of death, followed by craniocerebral injury. Notably, no reports of ischemic complications involving the pelvic organs due to IIAL were found. CONCLUSION: IIAL has a good effect in treating hemodynamically unstable pelvic fracture without the risk of pelvic organ ischemia. This procedure should be considered a priority for hemodynamically unstable pelvic fracture patients with abdominal organ injuries.

Asunto(s)

Fracturas Óseas , Hemodinámica , Arteria Ilíaca , Huesos Pélvicos , Humanos , Masculino , Fracturas Óseas/complicaciones , Fracturas Óseas/cirugía , Arteria Ilíaca/cirugía , Arteria Ilíaca/lesiones , Ligadura/métodos , Huesos Pélvicos/irrigación sanguínea , Huesos Pélvicos/lesiones

RESUMEN

Arterio-ureteral fistulas (AUFs), which are relatively rare but potentially life-threatening, require prompt diagnosis and treatment. We reported a case of AUFs following robot-assisted laparoscopic radical cystectomy (RARC) with extended pelvic lymph node dissection and ileal conduit urinary diversion for muscle-invasive bladder cancer, which resulted in massive hemorrhage. Urine leaked from the anastomosis between the ureter, and the end of the ileal conduit was infected, which resulted in an AUF between the pseudoaneurysm of the right common iliac artery and the ureter. The AUF was managed successfully by vascular intervention with an arterial stent graft.

Asunto(s)

Aneurisma Falso , Cistectomía , Arteria Ilíaca , Laparoscopía , Procedimientos Quirúrgicos Robotizados , Enfermedades Ureterales , Fístula Urinaria , Fístula Vascular , Humanos , Cistectomía/efectos adversos , Aneurisma Falso/etiología , Aneurisma Falso/cirugía , Fístula Urinaria/etiología , Fístula Urinaria/cirugía , Enfermedades Ureterales/etiología , Enfermedades Ureterales/cirugía , Arteria Ilíaca/cirugía , Fístula Vascular/etiología , Fístula Vascular/cirugía , Masculino , Complicaciones Posoperatorias/cirugía , Complicaciones Posoperatorias/etiología , Neoplasias de la Vejiga Urinaria/cirugía , Anciano , Persona de Mediana Edad

RESUMEN

A persistent sciatic artery (PSA) is a rare congenital vascular anomaly with an extremely low incidence of about 0.04%-0.06%. It is due to the persistence of the embryological axial limb artery, representing a continuation of the internal iliac artery into the thigh through the greater sciatic foramen below the piriformis muscle and down the thigh alongside the sciatic nerve. In normal embryologic development of the lower limb, the axial artery normally regresses after week 12. Persistent sciatic artery is often asymptomatic until a complication develops, it can be classified into two types, complete and incomplete. PSA can cause serious lower limb complications such as acute or critical limb ischemia.

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RésuméUne artère sciatique persistante (APS) est une anomalie vasculaire congénitale rare avec une incidence extrêmement faible d'environ 0,04 % à 0,06 %. Cela est dû à la persistance de l'artère axiale embryologique des membres, représentant une continuation de l'artère iliaque interne dans la cuisse à travers la grande foramen sciatique sous le muscle piriforme et le long de la cuisse le long du nerf sciatique. Dans le développement embryologique normal de la partie inférieure membre, l'artère axiale régresse normalement après la semaine 12. L'artère sciatique persistante est souvent asymptomatique jusqu'à ce qu'une complication se développe, elle peut être classés en deux types, complets et incomplets. Le PSA peut entraîner des complications graves des membres inférieurs telles qu'une ischémie aiguë ou critique des membres.

Asunto(s)

Arteria Ilíaca , Humanos , Arteria Ilíaca/anomalías , Arteria Ilíaca/diagnóstico por imagen , Masculino , Femenino , Resultado del Tratamiento , Malformaciones Vasculares/diagnóstico , Malformaciones Vasculares/diagnóstico por imagen , Extremidad Inferior/irrigación sanguínea , Muslo/irrigación sanguínea , Nervio Ciático/anomalías , Nervio Ciático/irrigación sanguínea , Nervio Ciático/diagnóstico por imagen

RESUMEN

Non-iatrogenic trauma of the iliac artery is rarely reported but is always life-threatening. In this report, we describe the case of a child with complete transection and partial disappearance of the iliac artery caused by bicycle handlebar impalement. He experienced catastrophic hemorrhage, malignant arrhythmia, and difficulty in exploring transected vessel stumps. Aggressive infusion, blood transfusion in time, and pediatric vascular characteristics help delay the deterioration during anesthesia induction. Eventually he was successfully rescued by performing interventional balloon occlusion and open revascularization after more than 7 h post-trauma. A series of interventions and precautionary methods may benefit such severely injured patients; thus, these methods should be highlighted.

Asunto(s)

Arteria Ilíaca , Humanos , Arteria Ilíaca/cirugía , Arteria Ilíaca/lesiones , Masculino , Niño , Ciclismo/lesiones , Oclusión con Balón/métodos , Lesiones del Sistema Vascular/cirugía , Lesiones del Sistema Vascular/etiología , Procedimientos Quirúrgicos Vasculares/métodos , Heridas no Penetrantes/cirugía

Asunto(s)

Colgajos Tisulares Libres , Arteria Ilíaca , Maxilar , Procedimientos de Cirugía Plástica , Humanos , Colgajos Tisulares Libres/irrigación sanguínea , Procedimientos de Cirugía Plástica/métodos , Arteria Ilíaca/cirugía , Arteria Ilíaca/trasplante , Maxilar/cirugía , Cara/cirugía , Cara/irrigación sanguínea

RESUMEN

A man in his mid-70s with a complex medical history, including splenectomy, presented with fever and rigours. Workup revealed Salmonella enterica serotype typhimurium bacteraemia and right internal iliac artery endarteritis. Two weeks following a 6-week course of antibiotics, he had a recurrence of Salmonella bacteraemia requiring an extended course of treatment.

Asunto(s)

Antibacterianos , Bacteriemia , Endarteritis , Arteria Ilíaca , Infecciones por Salmonella , Esplenectomía , Humanos , Masculino , Infecciones por Salmonella/complicaciones , Infecciones por Salmonella/diagnóstico , Infecciones por Salmonella/tratamiento farmacológico , Bacteriemia/tratamiento farmacológico , Bacteriemia/complicaciones , Bacteriemia/microbiología , Arteria Ilíaca/diagnóstico por imagen , Antibacterianos/uso terapéutico , Anciano , Recurrencia , Salmonella typhimurium/aislamiento & purificación

RESUMEN

Mycotic aneurysms of the iliac and other large arteries are rare and are associated with increased morbidity and mortality. Treatment of mycotic aneurysms usually requires modification of the surgical technique done for cases of degenerative or atherosclerotic aneurysms. Degenerative and atherosclerotic fusiform aneurysms are usually managed with aneurysmorrhaphy using a prosthetic graft, which however is not ideal for mycotic aneurysms. Avoidance of prosthetic material at the site of mycotic aneurysm is a better option with higher chances of resolution of infection and favorable patient outcome.

Asunto(s)

Aneurisma Infectado , Aneurisma Ilíaco , Humanos , Aneurisma Infectado/cirugía , Aneurisma Infectado/diagnóstico por imagen , Aneurisma Ilíaco/cirugía , Aneurisma Ilíaco/diagnóstico por imagen , Masculino , Resultado del Tratamiento , Implantación de Prótesis Vascular/métodos , Arteria Ilíaca/cirugía