Endovascular Management of Iliac Arterial Injury in Blunt Pelvic Trauma

Abstract

Iliac arterial injury in blunt pelvic trauma is rare, associated with fracture pelvis, massive retroperitoneal bleeding from the presacral, prevesical and venous plexuses, which is self-limiting but carries high mortality rate if it is allowed to re-expand after it was sealed. Most of the vascular injuries range from intimal injury with intimal flap formation to complete transection and total or partial occlusion by thrombus formation. Advances in endovascular therapy significantly change management of such vascular injuries and serves as a damage control helping the recovery from acute systemic injury and delay open surgical intervention. External fixation and endovascular management have increased in frequency and become the preferred method of intervention as it is safe with low complication rate. These are two case reports of two young males suffered blunt pelvic trauma, with huge retroperitoneal bleeding; left external iliac artery thrombosis managed with balloon mounted covered stent.