A successful hybrid operation for life-threatening hemorrhagic shock secondary to an iatrogenic ruptured pseudoaneurysm of the external iliac artery following percutaneous arterial access

Abstract

Intravascular treatments such as arterial embolization and resuscitative endovascular balloon occlusion of the aorta are being increasingly performed in emergency cases, in addition to the increasing use of arterial access as an intensive care monitoring tool. Thus, arterial access-related complications are being commonly reported. A 40- year-old man with renal artery stenosis underwent renal artery stent placement via the left inguinal puncture approach. After the procedure, his groin was manually compressed to hemostasis for 30 min. He unexpectedly developed shock the following day, and computed tomography revealed a ruptured pseudoaneurysm of the left external iliac artery (EIA) following iatrogenic vascular trauma owing to an inappropriately performed groin puncture. We initially controlled the hemorrhage using endovascular balloon occlusion of the left EIA. Subsequently, the injured EIA was repaired using a direct suture. The postoperative course was uneventful. Herein, we evaluated the causes of iatrogenic complications and the effectiveness of our treatment strategy.