Internal iliac complication

The advance of endovascular therapy for aorto-iliac aneurysmal disease has also brought about yet another flourishing application of embolotherapy. Embolization of the internal iliac artery plays an important adjunct initial modality to allow endovascular treatment of aortic aneurysms with extension into the common iliac arteries [78-80], It also plays an crucial role in the secondary management of complications related to endoleaks [81-84],... 

A spectrum of end-organ ischemic complications can occur with embolotherapy. Bowel infarction can complicate splanchnic embolization targeting bleeding or could result from inadvertent non-target embolization from an upstream source [88]. Gallbladder infarction or bile duct necrosis can complicate hepatic artery embolization or che-moembolization [89, 90]. Splenic abscess and overwhelming sepsis can occurs following splenic embolization [91]. Skin necrosis and nerve injury have been reported as a result of ethanol embolization of vascular malformations [53, 54]. Buttock muscular necrosis, buttock claudication and sexual dysfunction can occur as a result of internal iliac branch embolization, especially when distal or bilateral [92-95]. 

Razavi M, DeGroot M, Olcott C, Sze D, Kee S, Semba C, Dake M (2000) Embolization of the internal iliac artery in stent-graft treatment of aorto-iliac aneurysms Analysis of complications and outcome. J Vase Interv Radiol 11 561-566... 

Embolization, by definition, reduces blood flow distally. Therefore, it is no surprise that distal necrosis is a recognized complication of trauma embolization. However, unintentional reflux of embolization material from the internal iliac into the femoral artery can cause inadvertent ischemia in the leg. Sciatic palsy with associated foot drop and sacral plexus palsy has been reported [57]. Embolization of the superior gluteal artery in a patient vdio will be subjected to prolonged bedrest may cause sacral and buttock ischemia leading to skin break down [58]. Sexual dysfunction seems not to he a complication of bilateral internal iliac artery embolization, but is more likely a result of nerve injury secondary to the fracture or pelvic trauma [59]. 

---