Endovascular Management of Iatrogenic Arterial Injuries after Orthopedic Surgery of the Lower Limb

Barabino, Emanuele; Pittaluga, Giulia; Nivolli, Arianna; Ivaldi, Diego; Arnò, Matteo; Gazzo, Paolo

doi:10.1016/j.jvir.2023.02.004

Cited by 2 publications

(1 citation statement)

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“…As described here, massive hemorrhage with active bleeding after liposuction is an infrequent complication with potentially life-threatening consequences if not appropriately addressed [ 9 , 17 ]. Iatrogenic arterial injuries after orthopedic surgery have been well described [ 11 , 18 ], and embolization has been shown to be the safest and most effective treatment [ 19 , 20 ]. However, to our knowledge, only two cases of iatrogenic bleeding after liposuction have been reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Treatment with selective transcatheter arterial embolization of a ruptured profunda artery perforator after internal thigh liposuction: a case report

Tawa¹,

Boeken²,

Cetrulo³

et al. 2023

J Med Case Reports

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Background Hemorrhage is an uncommon complication of liposuction that may be trauma-induced by the cannula on the subcutaneous perforators. It usually resolves spontaneously with external compression and results in mild to moderate ecchymosis on the liposuction site. However, in sporadic cases, active bleeding may persist and require urgent intervention for hemostasis. Case presentation We report the case of a 60-year-old White female who developed a massive hematoma in the hour following liposuction of the right internal thigh, with active bleeding in the subcutaneous plane reported on contrast-enhanced computed tomography. The initial angiogram was conducted in the right common femoral artery and showed active bleeding from a profunda artery perforator. After careful selective catheterization of the feeding artery using a 2.0-French microcatheter, 0.3 mL of Onyx 34 was injected. Control angiography showed no immediate complication and confirmed the exclusion of the pseudoaneurysm. No postoperative event occurred. Blood pressure and hemoglobin levels remained stable throughout the episode. Conclusions Although liposuction is a very common procedure in plastic surgery, hemorrhagic complications may occur and require urgent hemostasis. This case suggests a vital place for interventional radiology in the management of hemorrhagic complications after liposuction.

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