External Iliac Vein Injury During Acetabular ORIF: Endovascular Rescue in Orthopaedic Trauma and Review of Surgical Considerations.
Bibhas Amatya, Michael A Holzman, Dipankar Mukherjee
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Case in brief
A patient undergoing acetabular open reduction and internal fixation (ORIF) experienced an iatrogenic external iliac vein injury, leading to massive hemorrhage. Due to limited visualization and high bleeding risk, an intraoperative endovascular approach was utilized. Aortic cuff stent-grafts were deployed via femoral access, achieving rapid hemostasis and preserving venous patency. Postoperative imaging confirmed successful outcomes.
Diagnostic / clinical pearl
Endovascular stent grafting can be a life-saving alternative to open repair for major iliac venous injuries during orthopedic procedures, especially in challenging anatomical situations.
Why it matters
This case underscores the necessity of preoperative vascular preparedness and the integration of endovascular techniques in orthopedic trauma surgery.