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Case Reports
. 2022 Jul 1;7(2):75-80.
doi: 10.22575/interventionalradiology.2021-0025.

Successful Closure of External Iliac Artery Perforation with Super-selective Transcatheter Coil Embolization

Kohei Hamamoto  1   2 , Noriko Oyama-Manabe  2 , Emiko Chiba  3 , Hiroshi Shinmoto  1
Affiliations
Case Reports

Successful Closure of External Iliac Artery Perforation with Super-selective Transcatheter Coil Embolization

Kohei Hamamoto et al. Interv Radiol (Higashimatsuyama). .

Abstract

We present two cases of external iliac artery perforation occurring after endovascular interventions successfully treated with direct closure using super-selective transcatheter coil embolization. Two patients, one 78-year-old man and one 78-year-old woman, underwent cardiac catheterization via the right femoral approach for coronary artery disease and atrial fibrillation. Following the procedures, both patients suffered severe acute hypotension, and contrast-enhanced computed tomography revealed a massive retroperitoneal hematoma due to perforation of the right external iliac artery. We attempted direct perforation site closure with super-selective transcatheter embolization using microcoils and achieved complete hemostasis in both cases. Our technique could be an alternative treatment option for external iliac artery perforations associated with the endovascular intervention.

Keywords: coil embolization; endovascular intervention; external iliac artery perforation; retroperitoneal hemorrhage.

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Conflict of interest statement

None

Figures

Figure 1.
Figure 1.
Contrast-enhanced CT images of Case 1. (a) Massive hematoma with extravasation of contrast medium is observed in the right peritoneal space. (b) Perforation is noted in the anterior side of the right external iliac artery (arrow). The diameter of the perforation site is 2.3 mm.
Figure 2.
Figure 2.
Contrast-enhanced CT images of Case 2. (a) Massive hematoma with extravasation of contrast medium is observed in the right peritoneal space. (b) Perforation is detected on the medial site of the right external iliac artery (arrow). The diameter of the perforation site is 2.1 mm.
Figure 3.
Figure 3.
Angiographic findings of Case 1. (a) Pretreatment arteriography shows extravasation of contrast medium from the distal portion of the right external iliac artery (arrowhead). The fistula-like finding was observed at the perforation site (arrow). (b) Engagement of the perforation site by an angiographic catheter. (c) Super-selective coil embolization with microcoils. (d) Posttreatment angiography reveals complete hemostasis and no evidence of residual blood flow in the perforation site.
Figure 4.
Figure 4.
Angiographic findings of Case 2. (a) Pretreatment arteriography shows extravasation of contrast medium from the distal portion of the right external iliac artery (arrowhead). The fistula-like finding was observed at the perforation site (arrow). (b) Engagement of the perforation site by an angiographic catheter. (c) Super-selective coil embolization with microcoils. (d) Posttreatment angiography reveals complete hemostasis and no evidence of residual blood flow in the perforation site.
See this image and copyright information in PMC

References

    1. Chan YC, Morales JP, Reidy JF, Taylor PR. Management of spontaneous and iatrogenic retroperitoneal haemorrhage: conservative management, endovascular intervention or open surgery? Int J Clin Pract. 2008; 62: 1604-1613. - PubMed
    1. O'Sullivan GJ, Ray SA, Lewis JS, et al. A review of alternative approaches in the management of iatrogenic femoral pseudoaneurysms. Ann R Coll Surg Engl. 1999; 81: 226-234. - PMC - PubMed
    1. Cooper SG, Sofocleous CT. Percutaneous management of angioplasty-related iliac artery rupture with preservation of luminal patency by prolonged balloon tamponade. J Vasc Interv Radiol. 1998; 9: 81-83. - PubMed
    1. Nyman U, Uher P, Lindh M, Lindblad B, Brunkwall J, Ivancev K. Stent-graft treatment of iatrogenic iliac artery perforations: report of three cases. Eur J Vasc Endovasc Surg. 1999; 17: 259-263. - PubMed
    1. Kufner S, Cassese S, Groha P, et al. Covered stents for endovascular repair of iatrogenic injuries of iliac and femoral arteries. Cardiovasc Revasc Med. 2015; 16: 156-162. - PubMed

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