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Successful Closure of External Iliac Artery Perforation with Super-selective Transcatheter Coil Embolization
Kohei Hamamoto1,2, Noriko Oyama-Manabe2, Emiko Chiba3
1Department of Radiology, National Defense Medical College, Japan.
Insights
This study details a novel treatment for external iliac artery perforation after endovascular procedures. Super-selective transcatheter coil embolization successfully achieved hemostasis in two patients, offering a new therapeutic option.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Radiology
Background:
- Endovascular interventions, while common for cardiovascular diseases, carry risks such as arterial perforation.
- External iliac artery perforation can lead to significant complications like retroperitoneal hematoma and hypotension.
Observation:
- Two patients experienced acute hypotension post-cardiac catheterization, diagnosed via CT scan as external iliac artery perforation and retroperitoneal hematoma.
- The perforations occurred after standard femoral artery access for coronary artery disease and atrial fibrillation treatment.
Findings:
- A minimally invasive technique of direct closure using super-selective transcatheter coil embolization was employed.
- Complete hemostasis was successfully achieved in both cases, resolving the acute complications.
Implications:
- This super-selective transcatheter coil embolization technique presents a viable alternative for managing external iliac artery perforations.
- The findings suggest a potentially safer and effective approach to mitigate complications from endovascular procedures.
Abstract:
We present two cases of external iliac artery perforation occurring after endovascular interventions successfully treated with direct closure using super-selective transcatheter coil embolization. Two patients, one 78-year-old man and one 78-year-old woman, underwent cardiac catheterization via the right femoral approach for coronary artery disease and atrial fibrillation. Following the procedures, both patients suffered severe acute hypotension, and contrast-enhanced computed tomography revealed a massive retroperitoneal hematoma due to perforation of the right external iliac artery. We attempted direct perforation site closure with super-selective transcatheter embolization using microcoils and achieved complete hemostasis in both cases. Our technique could be an alternative treatment option for external iliac artery perforations associated with the endovascular intervention.
