Consequences of hypogastric artery ligation, embolization, or coverage

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Gynecologic Surgery

Background:

• Interruption of the hypogastric artery (HA) can lead to ischemic complications.
• Understanding risk factors is crucial for patient safety across various surgical fields.

Purpose of the Study:

• To compare the incidence and risk factors of ischemic complications following HA interruption.
• To analyze outcomes based on patient demographics, surgical indication, and procedural techniques.

Main Methods:

• Systematic review of 124 papers including 394 patients.
• Data extraction on patient characteristics, procedure details, and complications.
• Comparative analysis of complication rates across different groups.

Main Results:

• Overall ischemic complication rate was 22.6%.
• Younger patients (<48.5 years), women, and OBG patients had significantly fewer complications.
• Ligation and proximal interruption were associated with lower complication rates compared to embolization and distal interruption, respectively.
• Specific complication rates included buttock claudication (12.2%), spinal cord ischemia (4.0%), and buttock necrosis (4.8%).

Conclusions:

• HA interruption is relatively safe in young and OBG patients.
• Ligation is preferred over embolization, and proximal over distal interruption to reduce ischemic risks.
• Further randomized controlled trials are needed to confirm risk factors and optimize techniques.