Isolated iliac artery @entity439 are rare but dangerous @entity439 associated with a high incidence of @entity397 (between 14 and 70%). @entity397 is frequently associated with an exceedingly high mortality primarily because of the elusive nature of the presenting symptoms and the resulting major delays in treatment. Accordingly these @entity439 are best managed aggressively. Although emerging endovascular techniques show promise surgical resection and reconstruction remains the gold standard for definitive management and has withstood the test of time with excellent durable and unparalleled results. That said, from an operative perspective these @entity439 are technically demanding and remain one of the more formidable technical challenges in vascular surgery. To highlight the key elements involved in a successful repair we present a right internal @entity1029 with an associated contralateral common iliac @entity432 , review the necessary preoperative planning and the available surgical treatment options, and detail the technical steps leading to a successful reconstruction. Careful operative planning is critical. Inadequate preoperative studies, inadequate preoperative decision making, and a poorly formulated operative strategy can lead to catastrophic results. Some of the most feared complications include pelvic @entity1317 with resulting massive @entity548 and postoperative pelvic @entity63 (with resulting rectal and/or @entity2759 ) which occurs as a result of inadequate contralateral collateral pelvic blood flow when the internal iliac artery is not reimplanted. Accordingly the preoperative workup must include a careful analysis of the adequacy of the contralateral pelvic blood flow to supply collateral flow in the event that the internal iliac is not reimplanted. In the presence of compromised contralateral internal iliac perfusion, resection and reconstruction or an alternative form of pelvic revascularization is mandatory. Excellent and unencumbered exposure is mandatory for a safe and successful repair. The retroperitoneal approach as illustrated in this case is strongly recommended. Although it is challenging excellent results can be achieved by resection of the @entity439 and reconstruction.

Isolated internal XXXX resection and reconstruction: operative planning and technical considerations.

@entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhage'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemia'] @entity2759 :: ('MESH:D020760', 'Disease') :: ['spinal cord ischemia'] @entity397 :: ('MESH:D012421', 'Disease') :: ['rupture', 'Rupture'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysms', 'aneurysm'] @entity432 :: ('MESH:D001157', 'Disease') :: ['artery occlusion'] @entity1317 :: ('MESH:D057772', 'Disease') :: ['venous injury'] @entity1029 :: ('MESH:D017543', 'Disease') :: ['iliac artery aneurysm']
@entity1029 :: (MESH:D017543,Disease) :: ['iliac artery aneurysm']
