Endovascular treatment of an iatrogenic perforation of the internal iliac vein.
We describe the case of a 48-year-old woman who developed a pelvic abscess after extensive surgery for recurrent ovarian cancer. While draining the abscess, a massive venous bleeding occurred. The bleeding was controlled by introducing a Foley catheter transrectally, occluding the perforated internal iliac vein. However, the catheter was positioned unintentionally in the inferior vena cava, causing hemodynamic instability. The iatrogenic perforation of the internal iliac vein was managed successfully with an endovascular approach using thrombin in combination with balloon-induced thrombosis. If iatrogenic venous bleeding occurs and the placement of a stent is precluded, balloon-induced thrombosis in combination with thrombin injection can be used successfully.
Department of Surgery, Ghent University Hospital, Ghent, Belgium. wouterwillaert@yahoo.co.uk
Wouter
W
Willaert
Isabelle
I
Van Herzeele
Wim
W
Ceelen
Dirk
D
Van De Putte
Frank
F
Vermassen
Piet
P
Pattyn
D021721:Balloon Occlusion; D004322:Drainage / Q000009:adverse effects; D057510:Endovascular Procedures; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy; D006489:Hemostatic Techniques; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D007049:Iatrogenic Disease; D007084:Iliac Vein / Q000000981:diagnostic imaging / Q000293:injuries*; D007275:Injections, Intravenous; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D013917:Thrombin / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*
D006490:Hemostatics; D013917:Thrombin