Open AccessEmergency Ligation of the External Iliac Artery
Author(s) -
I Blohmé,
H Brynger
Publication year - 1985
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-198504000-00017
Subject(s) - medicine , arterial insufficiency , external iliac artery , surgery , ligation , intermittent claudication , iliac artery , artery , claudication , hemodialysis , internal iliac artery , arterial disease , vascular disease
During a 19-year period, 35 of 1526 renal transplant operations were complicated by gross hemorrhage from infected arteriotomies. In 13 patients the common or external iliac artery was ligated and resected without immediate reconstruction for arterial continuity. There was no mortality from this procedure, and there was no limb loss. Early signs and symptoms of arterial insufficiency were rapidly reversed in most patients. Six patients, presently alive and 4-10 years after iliac artery ligation, were subjected to follow-up examinations of their distal circulation. One hemodialysis patient had slight symptoms of intermittent claudication, while the others were totally free of symptoms during daily activities. All patients had adequate distal arterial blood pressures. Postischemic maximal blood flows, obtained in three patients, were only slightly decreased. It is concluded that, for control of massive hemorrhage from infected arteriotomies in renal transplant patients, the iliac arteries can safely be ligated without immediate arterial reconstruction. The risk of limb loss is little but necessitates optimal postoperative support of the patient and close surveillance for early detection of irreversible arterial insufficiency.