Purpose
The aim of this study is to report an uncommon case of circumflex iliac artery perforation by inappropriate introduction of the hydrophilic guidewire in this artery during the performance of diagnostic arteriography.
Methods and Materials
- A 47-year-old male with chronic renal failure treated by hemodialysis and right lower limb ischemia grade IV admitted to our hospital for performing a diagnostic arteriography.
- Exploration was performed via right femoral artery and the guidewire was first introduced in circumflex iliac artery.
It was retired from this position and was advanced to abdominal aorta,
introduced the diagnostic catheter and completing exploration without incident.
- Four hours of the procedure,
patient presented acute pain and palpable mass in the right lower abdomen and...
Results
- The patient returned to our unit for diagnostic study and treatment.
- Transfemoral arteriography revealed circumflex iliac artery perforation with active extravasation of contrast.Fig. 2
The artery was embolized by using microcatheter and microcoils with technical and clinical succes. Fig. 3
- The patient was discharged a week later.
Conclusion
- The Seldinger technique of transfemoral catheterization is a safe procedure with an overall complication rate of 1% - 2%.
- Small haematomas at the femoral puncture site are relatively common,
easily recognized,
and usually insignificant.
- Pelvic and retroperitoneal haematomas secondary to angiography are uncommon.
- Haematomas of the abdominal wall or retroperitoneal cavity have been reported as a cause of acute abdomen.
- Spontaneous rectus sheath haematomas caused by the rupture of the inferior epigastric artery is a rare but well-known acute abdominal...
References
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Lateral abdominal wall hematoma as a rare complication aftercarotidartery stenting: a case report. FukunagaN,Ikeyama S,Satomi J,Satoh K.World J Emerg Surg.2009 Nov 12;4:39.
doi: 10.1186/1749-7922-4-39.
2.
Spontaneous hematoma of the lateral abdominal wall caused by a rupture of a deep circumflex iliac artery: report of two cases. Shimizu T,Hanasawa K,Yoshioka T,Mori T,Kajinami T,Yokoyama K,Sho K,Tani T. Surg Today.2003;33(6):475-8.
3 .
A case of spontaneous hemorrhage of the abdominal wall caused by rupture of a deep iliac circumflex artery treated by transcatheter arterial embolization. Katsumori T,Nakajima...