Internal Iliac Artery Ligation: A Series of 200 Patients

Burchell, R. Clay; Mengert, William F.

doi:10.1002/j.1879-3479.1969.tb00038.x

Cited by 15 publications

(9 citation statements)

References 2 publications

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“…Since the 1960s, intentional ligation of the IIA to reduce pelvic circulation and thereby minimize blood loss during gynecological procedures has been performed in young women with pelvic pathology. 3 These maneuvers were often lifesaving in the management of uncontrollable hemorrhage from pelvic arterial collaterals. One series reported on more than 200 patients treated by means of IIA ligation, with no apparent short-or longterm sequelae of pelvic ischemia.…”

Section: Discussionmentioning

confidence: 99%

Intentional internal iliac artery occlusion to facilitate endovascular repair of aortoiliac aneurysms

Yano

Morrissey

Eisen

et al. 2001

Journal of Vascular Surgery

162

123

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The incidence of pelvic ischemia after IIA occlusion is 20% immediately after endovascular aortoiliac aneurysm repair. A total of 25% of patients had no symptoms within 1 year. Two preoperative radiologic findings may help identify patients who are at risk for pelvic ischemia: stenosis of the patent IIA and disease deep femoral ascending branches ipsilateral to the occluded IIA. The risk of colon ischemia appears to be small after selective IIA occlusion to facilitate endovascular AAA repair.

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Section: Discussionmentioning

confidence: 99%

Intentional internal iliac artery occlusion to facilitate endovascular repair of aortoiliac aneurysms

Yano

Morrissey

Eisen

et al. 2001

Journal of Vascular Surgery

162

123

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“…ocurrió en una paciente enviada de otro Hospital en condiciones graves de shock y CID, en la cual todos los esfuerzos resultaron infructuosos. En esta serie se aplicaron diversas modalidades de tratamiento quirúrgico: legrado uterino, laparotomía, anexectomía, cesárea, cesárea-histerectomía y ligadura de hipogástricas con propósitos de vencer todas las posibilidades de sangrado y asegurar así la sobrevida (16,17,19,20,21,22,23,24,25). El caso de muerte experimentado revela que la hemorragia y el shock hemorrágico continúan siendo causa importante de mortalidad materna (2,9,10,11,12,16).…”

Section: Discussionunclassified

Shock hemorrágico de origen obstétrico

Orozco

Villacaqui

2015

Rev peru ginecol obstet.

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Se presenta el estudio de 49 casos de shock hemorrágico tratados en el Departamento de Ginecoobstetricia del Hospital de Apoyo "María Auxiliadora", dentro de un total de 6,243 partos atendidos desde el 01 de Julio de 1988 al 31 de Diciembre de 1989. El shock hemorrágico se presentó con una frecuencia de 01 caso por cada 127 partos, siendo las causas más frecuentes los problemas del primer trimestre del embarazo, el embarazo ectópico y el aborto. Ocupa también lugar importante como causa del shock el desprendimiento prematuro de placenta. Llama la atención la menor frecuencia de problemas de hemorragia postparto y particularmente de la atonía uterina, la que encontramos únicamente en dos casos. Este último seguramente en relación con nuestra conducta preventiva frente a esa eventualidad. De acuerdo a la estructura de causas no llama la atención que la cronología del embarazo encontrada, estuviera dentro de las primeras 12 semanas. El manejo se hizo sobre un esquema que comprende medidas generales y específicas para cohibir el sangrado. Ello incorporó procedimientos quirúrgicos variados. De los 49 casos tratados 48 sobrevivieron y falleció una paciente. También fue importante quede 23 productos de la concepción que superaron la edad gestacional de 28 semanas, sólo sobrevivieron 8, lo que confirma que el shock hemorrágico no sólo afecta a la madre, sino que además tiene graves consecuencias sobre el niño.

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“…The primary hemodynamic effect following bilateral IIA ligation is the nearly complete elimination of blood pressure in small arteries distal to the ligation, effectively transforming the arterial system into a venous one. As a result, a hemostatic mechanism develops, leading to the formation and retention of clots [ 44 , 59 , 60 , 61 ]. The pulse pressure and arterial blood pressure distal to the ligation decrease by 85% (with bilateral IIA ligation) and 25% (bilateral IIA ligation), respectively [ 59 , 60 , 61 ].…”

Section: Hemodynamics After Iia Ligationmentioning

confidence: 99%

Internal Iliac Artery Ligation in Obstetrics and Gynecology: Surgical Anatomy and Surgical Considerations

Kostov,

Kornovski,

Watrowski

et al. 2023

Clinics and Practice

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The internal iliac artery (IIA) is the main arterial vessel of the pelvis. It supplies the pelvic viscera, pelvic walls, perineum, and gluteal region. In cases of severe obstetrical or gynecologic hemorrhage, IIA ligation can be a lifesaving procedure. Regrettably, IIA ligation has not gained widespread popularity, primarily due to limited surgical training and concerns regarding possible complications, including buttock claudication, impotence, and urinary bladder and rectum necroses. Nowadays, selective arterial embolization or temporary balloon occlusion are increasingly utilized alternatives, which can be applied preoperatively or intraoperatively for threatening severe genital or pelvic bleeding. However, IIA ligation retains its relevance, as the previously described procedures are not always available and have limitations. This article provides a step-by-step guide to the IIA ligation procedure and its possible complications. It also includes a detailed description of the anatomy of the IIA and pelvic arterial anastomoses. This review highlights the importance of a thorough understanding of pelvic anatomy as a prerequisite for safe IIA ligation and posits that training in this procedure should be an integral part of obstetrics and gynecology curricula.

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Internal Iliac Artery Ligation: A Series of 200 Patients

Cited by 15 publications

References 2 publications

Intentional internal iliac artery occlusion to facilitate endovascular repair of aortoiliac aneurysms

Intentional internal iliac artery occlusion to facilitate endovascular repair of aortoiliac aneurysms

Shock hemorrágico de origen obstétrico

Internal Iliac Artery Ligation in Obstetrics and Gynecology: Surgical Anatomy and Surgical Considerations

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