Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Endovascular Treatment of Iatrogenic Iliac Vein Rupture during Total Hip Arthroplasty: A Case Report

고관절치환술 중 발생한 의인성 장골 정맥 파열의 인터벤션 치료: 증례 보고

  • Dong Hyuk Yang (Department of Radiology, Gil Medical Center, Gachon University College of Medicine) ;
  • Suyoung Park (Department of Radiology, Gil Medical Center, Gachon University College of Medicine) ;
  • Jeong Ho Kim (Department of Radiology, Gil Medical Center, Gachon University College of Medicine) ;
  • Jung Han Hwang (Department of Radiology, Gil Medical Center, Gachon University College of Medicine)
  • 양동혁 (가천대학교 의과대학 길병원 영상의학과) ;
  • 박수영 (가천대학교 의과대학 길병원 영상의학과) ;
  • 김정호 (가천대학교 의과대학 길병원 영상의학과) ;
  • 황정한 (가천대학교 의과대학 길병원 영상의학과)
  • Received : 2024.01.07
  • Accepted : 2024.03.15
  • Published : 2024.10.01
Download PDF
⟨ Previous Next ⟩

Abstract

We present a case of iatrogenic iliac vein rupture with venous thrombosis during total hip arthroplasty that was endovascularly treated with the insertion of covered and uncovered stents, aspiration, and balloon maceration of the thrombus. We describe in detail, with a schematic diagram, an endovascular treatment method that can be performed under local anesthesia alone and explain how to overcome the situation when the diameter of the covered stent is inadequate to cover the iliac vein.

저자들은 고관절치환술 중 발생한 의인성 장골 정맥 파열과 정맥 혈전증을 커버드 스텐트(covered stent)와 언커버드 스텐트(uncovered stent 또는 bare metal stent)의 삽입과 혈전의 흡인 및 풍선 파쇄로 인터벤션 치료한 사례를 소개하고자 한다. 국소 마취만으로 시술할 수 있는 인터벤션 치료 방법에 대해 자세히 설명하고, 커버드 스텐트의 지름이 장골 정맥을 충분히 덮지 못하는 상황에 대한 극복 방법을 모식도와 함께 설명하였다.

Keywords

References

  1. Kataoka Y, Maekawa K, Nishimaki H, Yamamoto S, Soma K. Iliac vein injuries in hemodynamically unstable patients with pelvic fracture caused by blunt trauma. J Trauma 2005;58:704-708; discussion 708-710 
  2. Ayob KA, Merican AM, Sulaiman SH, Hariz Ramli AR. The tale of two vessels, vascular complications following a breach of the pelvic inner table due to acetabular screws: a report of two cases. Jt Dis Relat Surg 2021;32:239-244 
  3. Ohashi H, Kikuchi S, Aota S, Hakozaki M, Konno S. Surgical anatomy of the pelvic vasculature, with particular reference to acetabular screw fixation in cementless total hip arthroplasty in Asian population. J Orthop Surg (Hong Kong) 2017;25:2309499016685520 
  4. Sofue K, Sugimoto K, Mori T, Nakayama S, Yamaguchi M, Sugimura K. Endovascular uncovered Wallstent placement for life-threatening isolated iliac vein injury caused by blunt pelvic trauma. Jpn J Radiol 2012;30:680-683 
  5. Cha JG, Lee SY, Hong J, Park JM, Lim KH, Kim D. Traumatic iliac vein rupture managed using a bare-metal stent. Trauma Case Rep 2021;37:100589 
  6. Schoeff JE, Israel TR, Green TJ, Weaver JS, Zarkowsky DS. Expedient endovascular hemorrhage control during anterior lumbar spinal exposure allows procedural completion in rescued patients. Ann Vasc Surg 2022;78:377.e5-377.e10 
  7. Raju S, Buck WJ, Crim W, Jayaraj A. Optimal sizing of iliac vein stents. Phlebology 2018;33:451-457 
  8. Sayed MH, Salem M, Desai KR, O'Sullivan GJ, Black SA. A review of the incidence, outcome, and management of venous stent migration. J Vasc Surg Venous Lymphat Disord 2022;10:482-490 
  9. Ogura T, Nishioka N, Yamada M, Yamada T, Higuchi K. Comparison study between double bare covered and fully covered metal stent during endoscopic ultrasound-guided choledochoduodenostomy (with video). Dig Dis 2021;39:165-170