Gluteal necrosis and paraplegia following postoperative bilateral internal iliac artery occlusion

Complications associated with occlusion of the internal iliac arteries are seen less commonly than those following occlusion of the external iliac arteries, because the pelvis has a good collateral circulation. This paper describes a case of severe gluteal necrosis, paraplegia and acute renal failure following an aorto-bifemoral bypass, which we believe was caused by bilateral iliac artery and pelvic collateral circulation occlusion.