title: Iliac vessel injuries: difficult injuries and difficult management problems.
abstract: BACKGROUND
  Injury to the iliac vessels poses a serious and frustrating treatment dilemma for all trauma surgeons. Generally, patients present in profound shock secondary to severe hemorrhage from either iliac arterial, venous, or combined injuries. Despite improvements in our emergency medical services (EMS), rapid transport, standard training of trauma surgeons, and improved technology, the morbidity and mortality from iliac vessel injuries remain high, ranging from 25 to 40 %.
  
  
  METHODS
  A systematic review of the literature, with emphasis placed on the diagnosis, treatment, and outcomes of these injuries, incorporating the author's experience.
  
  
  CONCLUSIONS
  Injuries to the iliac vessel remain a daunting task, even after great advances in anatomic injury grading and damage control as well as advances in surgical techniques and critical care. Despite all the advances in treatment and appropriate management strategies, the morbidity and mortality from iliac vessel injuries remain high, demonstrating the complex challenge their treatment presents to even the modern-day trauma surgeon.
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA.
authors.forename: M
authors.initials: M
authors.lastname: Ksycki
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA.
authors.forename: G
authors.initials: G
authors.lastname: Ruiz
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Perez-Alonso
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Sciarretta
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA.
authors.forename: R
authors.initials: R
authors.lastname: Gonzalo
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA.
authors.forename: E
authors.initials: E
authors.lastname: Iglesias
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA.
authors.forename: A
authors.initials: A
authors.lastname: Gigena
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA.
authors.forename: T
authors.initials: T
authors.lastname: Vu
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA. jasensio@med.miami.edu.
authors.forename: J A
authors.initials: JA
authors.lastname: Asensio
keywords: Abdominal trauma; Pelvic trauma; Vascular trauma
references.citation: Ann Surg. 1989 Jun;209(6):698-705; discussion 706-7
references.pmid: 2730182
references.citation: Am Surg. 2003 Jul;69(7):581-6
references.pmid: 12889621
references.citation: Arch Surg. 2003 Nov;138(11):1187-93; discussion 1193-4
references.pmid: 14609865
references.citation: Am J Surg. 1982 Dec;144(6):642-5
references.pmid: 7149122
references.citation: Surgery. 1958 Sep;44(3):604-10
references.pmid: 13647204
references.citation: Ann Surg. 1953 Aug;138(2):158-77
references.pmid: 13066006
references.citation: Surgery. 1969 Jan;65(1):218-26
references.pmid: 5762414
references.citation: Mil Med. 1959 Jan;124(1):30-46
references.pmid: 13622271
references.citation: Am Surg. 2001 Jun;67(6):565-70; discussion 570-1
references.pmid: 11409805
references.citation: Surg Clin North Am. 2002 Feb;82(1):21-48, xix
references.pmid: 11905947
references.citation: Ann Surg. 1946 Apr;123(4):534-79
references.pmid: 17858758
references.citation: Am J Surg. 2000 Dec;180(6):528-33; discussion 533-4
references.pmid: 11182412
references.citation: Ann Surg. 2011 Jun;253(6):1184-9
references.pmid: 21217514
references.citation: J Trauma. 1970 May;10(5):359-69
references.pmid: 4909463
references.citation: Surgery. 1966 Feb;59(2):203-9
references.pmid: 5913491
references.citation: J Trauma. 2010 Dec;69(6):1393-7
references.pmid: 20693922
references.citation: J Cardiovasc Surg (Torino). 1970 Sep-Oct;11(5):368-77
references.pmid: 5493252
references.citation: Ann Surg. 1955 Mar;141(3):297-303
references.pmid: 14350568
references.citation: Surg Gynecol Obstet. 1954 Jul;99(1):91-100
references.pmid: 13168855
references.citation: J Trauma. 1998 Jun;44(6):1024-9; discussion 1029-30
references.pmid: 9637158
references.citation: Surgery. 1983 Oct;94(4):598-603
references.pmid: 6623360
references.citation: Mil Med. 1968 Jan;133(1):9-22
references.pmid: 4966207
references.citation: J Trauma. 1990 Mar;30(3):320-3
references.pmid: 2313751
references.citation: Surgery. 1958 Feb;43(2):175-83
references.pmid: 13543589
references.citation: Am J Surg. 1981 Dec;142(6):695-8
references.pmid: 7316035
references.citation: J Trauma. 2001 Jun;50(6):1020-6
references.pmid: 11426115
references.citation: J Trauma. 1990 Dec;30(12):1450-9
references.pmid: 2258955
references.citation: Ann Vasc Surg. 1990 Sep;4(5):415-8
references.pmid: 2223538
references.citation: J Trauma. 1997 Jun;42(6):1033-40
references.pmid: 9210537
references.citation: Ann Surg. 1958 Apr;147(4):555-61
references.pmid: 13521671
references.citation: J Am Coll Surg. 2007 Apr;204(4):625-32
references.pmid: 17382222