title: Crossover Thrombectomy of Hypogastric Arteries.
abstract: To describe a case of intraoperative thrombotic occlusion of the left hypogastric artery (HA) during endovascular treatment for acute Leriche syndrome and a feasible technique for HA embolectomy and prevention of pelvic ischemia. After bilateral transfemoral vascular access Fogarty thrombectomy of the infrarenal aorta and bilateral common and external iliac arteries was performed. Then, an intraoperative angiography revealed new thrombotic occlusion of the left HA. Ipsilateral transfemoral approach was impeded by a strong angulation between HA and iliac artery. Therefore, a right-transfemoral approach was used for crossover Fogarty thrombectomy. The thrombus was mobilized into the left common iliac artery and could easily be removed by left-transfemoral embolectomy. No complications occurred. Crossover thrombectomy is a feasible technique for endovascular treatment of acute thrombotic occlusion of HAs. Occlusion of HA should be treated whenever possible.
authors.affiliation: Department of Vascular and Endovascular Surgery, University Hospital of Duesseldorf, Duesseldorf, Germany. Electronic address: philip.dueppers@med.uni-duesseldorf.de.
authors.forename: Philip
authors.initials: P
authors.lastname: Dueppers
authors.affiliation: Department of Vascular and Endovascular Surgery, University Hospital of Duesseldorf, Duesseldorf, Germany.
authors.forename: Hubert
authors.initials: H
authors.lastname: Schelzig
authors.affiliation: Department of Vascular and Endovascular Surgery, University Hospital of Duesseldorf, Duesseldorf, Germany.
authors.forename: Markus Udo
authors.initials: MU
authors.lastname: Wagenhäuser
authors.affiliation: Department of Vascular and Endovascular Surgery, University Hospital of Duesseldorf, Duesseldorf, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Oberhuber
mesh_terms: D000368:Aged; D057510:Endovascular Procedures; D006801:Humans; D007083:Iliac Artery; D007925:Leriche Syndrome / Q000150:complications / Q000601:surgery*; D008297:Male; D017131:Thrombectomy; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*