Patient 74 years old, limiting buttock claudication in a patient with a previos fem-pop bypass
Case of the last week: Patient 74 years old, limiting buttock claudication in a patient with a previos fem-pop bypass, actually with positive pedal pulse in that leg. Negative probes for Hip or Spine problems, AngioCT scan shows selective right hypogastric occlusion with distal gluteal and pudenda patent arteries. Game plan: contralateral access, intraluminal recanalization and angioplasty in kissing ballon maneuver. After achieve distal recanalization and predilation with 4mm ballon, internal pudenda distal artery rupture was identify in the control angio, fixed with micro coils hashtag#interlock embolization from Boston Scientific. Distal gluteal recanalization and reangioplasty with 5mm ballon. Excellent result in final angio with direct flow to the gluteal area. Patient lost 3 gr. of Hb during 5 minutes bleeding.
What we learn in this case?
– Be aware with distal branches in Pelvic area. No control of bleeding and fast blood lost.
-Always have a plan B on mind for posible complications.
MD Angiology and Vascular Surgery
Chief of Angiology, Vascular and Endovascular Surgery Department. Hospital quironsalud Marbella and Campo de Gibraltar.
IVEI Senior Consultant / Director de IVEI.