Placenta percreta: Balloon occlusion and embolization of the internal iliac arteries to reduce intraoperative blood losses

Delayed bleeding after prophylactic bilateral internal iliac artery balloon occlusion in elective caesarean hysterectomy for the management of placenta accreta

“…11 This is followed by prophylactic internal iliac artery balloon occlusion which was successfully used in two patients with placenta percreta. 8 The goal of internal iliac artery balloon occlusion is to temporarily occlude the internal iliac arteries in order to reduce uterine perfusion and decrease the rate of blood flow, thereby reducing blood loss, improving visualization during surgery, allowing for urgent arterial embolization (if require), and possibly preventing hysterectomy. 12 However, until now there is still a lack of significant evidence showing the benefit in terms of haemorrhage control and uterus preservation.…”

“…1 Although the choice treatment for placenta accrete is puerperal hysterectomy, it involves greater risk of intraoperative haemorrhage. 8 The bleeding is usually treated with bilateral ligation of the uterine arteries or the internal iliac arteries. 9 However, due to the vast network of collateral arteries in the pelvis, particularly during pregnancy, adequate control of this bleeding is possible in less than 42% of the cases, particularly when there is involvement of the adjacent structures, such as bladder, colon, and ureter.…”

Complication of Femoral Arterial Thrombosis Following Failure of Balloon Tamponade and Massive Blood Loss During Hysterectomy in a Case of Abnormal Placentation

“…Dubois et al first described its successful use in two cases [2]. A case series reported experience of IIOBC in 14 patients of placenta accreta [3].…”

Iliac artery rupture related to balloon insertion for placenta accreta causing maternal hemorrhage and neonatal compromise

“…4 Since then, multiple reports examining the use of these balloons have been published. 3 The rate of complications related to the procedure has been estimated to be 6-15.8%.…”