Pseudoaneurysm of the external iliac artery after total hip arthroplasty – a case report
DOI:
https://doi.org/10.48750/acv.539Keywords:
iliac artery, pseudoaneurysm, otal hip arthroplasty, latrogenic diseaseAbstract
BACKGROUND: Delayed arterial injury after total hip arthroplasty is unusual and the consequences of this complication are serious and potentially life threatening.CASE REPORT: We present a case of pseudoaneurysm of the external iliac artery occurring 6 years after total hip replacement revision due to infected acetabular cup protrusion. Due to the presence of prosthetic infection, the patient was managed with urgent ligation of external iliac artery and femoro-femoral bypass. Afterwards, a Girdlestone procedure was performed. This was selected according to patient comorbidities and previous interventions. The patient recovered ambulatory function and no late complications were observed.
CONCLUSION: This report suggests that a careful and long-term follow-up of patients who have undergone hip surgery should be considered, as well as patient information regarding possible late complications. Moreover, treatment decision must be made according to patient circumstances, resources available and surgical experience.
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References
Nachbur B, Meyer RP, Verkkala K, Zürcher R. The mechanisms of severe arterial injury in surgery of the hip joint. Clin Orthop Relat Res. 1979;141:122-33.
Fukuhara S, Kanki S, Daimon M, Shimada R, Ozawa H, Katsumata T. Pseudoaneurysm of the external iliac artery is a rare late complication after total hip arthroplasty. J Vasc Surg Cases Innov Tech. 2017;3:149-51.
Abularrage CJ, Weiswasser JM, Dezee KJ, Slidell MB, Henderson WG, Sidawy AN. Predictors of lower extremity arterial injury after total knee or total hip arthroplasty. J Vasc Surg. 2008;47:803-7
Shahait AD, Chagas C, Hussein S, Bhat Z. Unique case of delayed external iliac artery pseudoaneurysm after a remote total hip arthroplasty. BMJ Case Rep. 2019;12: e226661.
Wilson JS, Miranda A, Johnson BL, Shames ML, Back MR, Bandyk DF. Vascular injuries associated with elective orthopedic procedures. Ann Vasc Surg. 2003;17:641-4.
Ocke Reis PE, Roever L, Ocke Reis IF, de Azambuja Fontes F, Rotolo Nascimento M, Nunes Dos Santos L, et al. Endovascular Stent Grafting of a Deep Femoral Artery Pseudoaneurysm. EJVES Short Rep. 2016;33:5-8.
Ramakrishnan P, Hote MP, Sreedhar N, Kumar S, Malik V, Choudhary SK. Internal iliac artery pseudoaneurysm: a rare presentation with foot drop and sciatica. Indian J Thorac Cardiovasc Surg. 2019;35:222-5.
Scavee V, Vranckx P, Pauls C, Donnay M, Heymans M, Van Der Elst P. Femoral bifurcation infected pseudoaneurysm: a simple and quick arterial reconstruction with reversed bifurcated saphenous vein graft. Int Angiol. 2009;28:161-3.
Li K, Beckerman WE, Luo X, Peng HW, Chen KQ, He CG. Graft Infection after Prosthetic Bypass Surgery for Infectious Femoral Artery Pseudoaneurysm in Intravenous Drug Users: Manifestation, Management, and Prognosis. Ann Vasc Surg. 2021;70:449-58.
Shoenfeld NA, Stuchin SA, Pearl R, Haveson S. The management of vascular injuries associated with total hip arthroplasty. J Vasc Surg. 1990;11:549-55.
