Management of iatrogenic iliac artery injury complicating angiographic procedures

ABSTRACT

Twenty one patients with iatrogenic iliac artery injury complicating diagnostic [4] and interventional [17] angiographic procedures were managed from February 1994 to April 1999. Clinically they presented with acute lower limb ischemia [16], progressive retroperitoneal bleeding [4] and progressively growing false aneurysm [1]. Patients were managed by one or more of the following 8 femorofemoral bypass, 8 iliac stent [with one failure], 3 balloon catheter thrombectomy [all failed], and 6 iliac exploration and proceed [with one mortality]. We conclude that for iliac occlusion, femorofemoral bypass is a safe and reliable option. With endovascular and imaging facilities, iliac stenting should be the first choice if possible. Blind thrombectomy is dangerous and should not be attempted. Temporary balloon tamponade is useful to stop bleeding in iliac artery rupture which should be managed without delay