What is hypogastric artery ligation?
Hypogastric (internal iliac) artery ligation was pioneered by Howard Kelly for the treatment of intraoperative bleeding from cervical cancer prior to its application in postpartum hemorrhage (PPH). Many studies have reported that hypogastric artery ligation can be life-saving in patients with massive pelvic bleeding.
Which division of internal iliac vessel is ligated in management of PPH?
Ligation of the IIA has a proven success rate in controlling massive pelvic hemorrhage, varying between 40% and 100%, and obstetric pathologies occupy the first place as the leading factor (11,12).
Can internal iliac artery be ligated?
Internal iliac artery ligation can be effective to reduce bleeding from all sources within the genital tract by reducing the pulse pressure in the pelvic arterial circulation. One study indicated that pulse pressure was reduced by 77% with unilateral ligation and by 85% with bilateral ligation.
Which artery is ligated in PPH?
Bilateral ligation of the uterine vessels (O’Leary stitch) is the preferred approach for controlling PPH from laceration of the uterine artery or branches of the utero-ovarian artery. If this does not control bleeding, the vessels of the utero-ovarian arcade are similarly ligated.
What is artery ligation?
With a blood vessel the surgeon will clamp the vessel perpendicular to the axis of the artery or vein with a hemostat, then secure it by ligating it; i.e. using a piece of suture around it before dividing the structure and releasing the hemostat.
What is Hypogastric?
Definition of hypogastric : of or relating to the lower median region of the abdomen.
How do you know if you have a hypogastric artery?
The distal two-thirds of the same line delineates the external iliac artery; a line dropped medioinferiorly from this junction to the pelvic floor suggests the course of the hypogastric artery. The external bony landmark to the level of the bifurcation of the common iliac artery is the anterosuperior iliac spine.
What is Ligate artery?
Which artery is ligated in epistaxis?
Ligation of the external carotid artery for severe epistaxis.
Which arteries can be ligated?
The external carotid, subclavian, axillary, internal iliac arteries can be ligated with few consequences. Ligation of the internal carotid artery carries a 10-20% risk of developing a stroke.
What happens to a ligated vein?
Surgery Overview Vein ligation and stripping is a minor surgery. It is used to remove a damaged vein and prevent complications of vein damage. If several valves in a vein and the vein itself are heavily damaged, the vein (or the diseased part of the vein) is removed (stripped).
How is hypogastric (internal iliac) artery (iliac) ligation performed?
Ligation of the hypogastric (internal iliac) artery can be performed either via an open approach (intraperitoneal or extraperitoneal) or via an endovascular approach.
What are the possible complications of hypogastric artery ligation?
Specific complications of hypogastric artery ligation may include the following: Infertility and impotence in men. Buttock and thigh claudication. Damage to the ureter. Ischemic limb from damage to common or external iliac artery. Damage to other pelvic vessels.
What are the risks of bilateral iliac artery ligation?
It is for this reason that other workers have advocated bilateral ligation of the internal iliac arteries to significantly improve the chances of reducing pelvic pulse pressure and facilitate hemostasis5. Reported complications include nerve injury, inadvertent ligature of the common iliac artery, prolonged blood loss and prolonged operative time.