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Percutaneous Intervention of Iatrogenic Iliac Artery Vascular Complication

Sabah Siddiqui1, Sergey Ayzenberg1, Ahmad Morshed1

  • 1Cardiology, Maimonides Medical Center, Brooklyn, USA.

Cureus
|October 8, 2020
PubMed

Insights

Retroperitoneal hematoma can be fatal if not treated promptly. This case demonstrates successful endovascular repair of a right external iliac artery perforation, a complication of cardiac catheterization, using a covered stent.

Area of Science:

  • Cardiology
  • Interventional Radiology
  • Vascular Surgery

Background:

  • Retroperitoneal hematoma carries a high mortality rate, especially with delayed or inadequate treatment.
  • Percutaneous endovascular repair is emerging as a preferred treatment for iatrogenic vascular complications.

Observation:

  • A 76-year-old female presented with non-ST-elevation myocardial infarction and left main coronary artery stenosis.
  • Following successful percutaneous coronary intervention, she developed acute hypotension due to a retroperitoneal hematoma.
  • Diagnostic angiography identified a right external iliac artery perforation as the cause.

Findings:

  • The patient underwent successful endovascular repair of the right external iliac artery perforation using a covered stent.
  • This minimally invasive approach was chosen due to high cardiac risk associated with traditional vascular surgery post-PCI.

Implications:

  • Early diagnosis and prompt intervention are crucial for managing retroperitoneal hematoma.
  • Intravascular interventions in the cardiac catheterization lab offer a viable solution for vascular complications post-cardiac procedures.
  • This case underscores the importance of multidisciplinary collaboration in managing complex cardiovascular emergencies.

Keywords:
complex pcicovered stentslmcapercutaneous endovascular repairretroperitoneal hemorrhage

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