Embolisation for Vascular Injuries Complicating Elective Orthopaedic Surgery

Mavrogenis, Af; Rossi, Giuseppe; Rimondi, Eugenio; Ruggieri, Pietro; Mercuri, Mario

doi:10.1016/j.ejvs.2011.04.009

Cited by 15 publications

(1 citation statement)

References 34 publications

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“…The course of the IGA has been studied in the Caucasian and Asian populations and although the posterosuperior quadrant has been described to be relatively safe, the surgeon needs to be wary of the length of the drill or the screw, particularly in proximity to the sciatic notch, where even a short screw may put the gluteal vessels at risk. [1,2] The reported incidence of IGA injury is rare, we only identified two cases from previously published case series by Mavrogenis et al [8] and Cheng et al, [9] both occurring as a complication from THA and treated with embolization.…”

Section: Discussionmentioning

confidence: 99%

The tale of two vessels, vascular complications following a breach of the pelvic inner table due to acetabular screws: a report of two cases

et al. 2021

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Injuries to the pelvic vasculature during total hip arthroplasties are rare but have serious consequence. They demand urgent and early identification so that appropriate treatment can be instituted. If the bleeding is severe, cardiovascular compromise occurs intraoperatively and this will alert the surgeon of this possibility during acetabular screw placement. Alternatively, a delay in diagnosis can occur because the bleeding and the injured vessel are in the pelvic cavity and not visualized during the surgery. In this article, we report two cases from our center occurring within a six-month interval that sustained a vascular injury during acetabular drilling for screw placement for cementless cup fixation. Each case had a different vessel injury and different lessons can be learned from these rare injuries. The first case had an injury of the inferior gluteal artery following a breach of the sciatic notch. The vessel was treated with percutaneous embolization. The second case demonstrated a venous injury, following a medial protrusio technique for congenital hip dysplasia and a short anterosuperior screw, transecting the external iliac vein. This was subsequently repaired using an endovascular technique. We conclude the reasons for these vessel injuries after analyzing advanced imaging, discuss measures to avoid vessel injury and detail the minimally invasive method for their treatment.

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Section: Discussionmentioning

confidence: 99%