A Novel Technique to Control Internal Iliac Artery Back Bleeding

Abstract

The reported mortality rate following repair of ruptured aorto-iliac aneurysms range from 24–95%. The cause of post-operative morbidity and mortality is multifactorial, including haemorrhage, coagulopathy, cardiac events, renal failure and multi-organ failure. Surgical repair of ruptured abdominal and aorto-iliac aneurysms is technically difficult due to retro peritoneal and pelvic haematomas which obscure the anatomy, making control of the iliac and aortic vessels more difficult. The internal iliac artery lies deep within the pelvis and lies in close proximity to large iliac veins, making it a difficult artery to control in these circumstances. We describe a method of occluding the internal iliac artery with a piece of Polypropylene knitted Non-absorbable Mesh (Prolene, Johnson & Johnson Intl., UK) and Oxidised Regenerated Cellulose (Surgicel, Johnson & Johnson Intl., UK) to control haemorrhage during repair of rupture of an aorto-iliac aneurysm.