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Endovascular Repair of Iliac Vein Laceration Associated with Complex Pelvic Fracture.

Abstract：

BACKGROUND:Iliac vein injury associated with pelvic fracture due to blunt trauma is an uncommon and difficult diagnosis but a life-threatening condition which often requires an emergent management. Although open repair has been traditionally used as the treatment of choice in unstable patients, it is controversial, given the difficulty due to injured vessel exposure in patients with significant retroperitoneal hematoma as well as tamponade effect loss associated with laparotomy. We present a challenging case of iliac vein laceration successfully treated by placement of a self-expanding covered stent. METHODS:A 15-year-old male was hemodynamically unstable and was transferred to our emergency department after a severe polytrauma due to a motorcycle accident. Contrast-enhanced computed tomography showed a left external iliac vein laceration with active bleeding and retroperitoneal hematoma as well as complex pelvic and left supracondylar femoral fractures. A 13 × 100 mm self-expanding covered stent was successfully deployed through duplex ultrasound-guided percutaneous approach of both femoral veins. RESULTS:The patient's blood pressure was normalized as soon as the stent graft was placed, and then femoral fracture was reduced and fixed. At 12-month follow-up, the patient remained asymptomatic, and stent-graft patency was confirmed. CONCLUSIONS:Covered stent-graft placement can be an effective and rapid treatment for life-threatening iliac vein injury.

journal_name

Ann Vasc Surg

journal_title

Annals of vascular surgery

authors

Mosquera Rey V,Fernández C,Zanabili A,Del Castro JA,Pandavenes MG,Alonso M

doi

10.1016/j.avsg.2018.06.020

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

336.e9-336.e12

eissn

0890-5096

issn

1615-5947

pii

S0890-5096(18)30602-2

journal_volume

54

pub_type

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