The prevention and management of approach-specific complications of abdominal aortic balloon occlusion in pelvic and sacral surgery
10.3760/cma.j.cn112139-20210527-00226
- VernacularTitle:骨盆、骶骨肿瘤切除术中应用腹主动脉球囊的股动脉穿刺相关并发症的预防和处理
- Author:
Zhiqing ZHAO
1
;
Sen DONG
;
Jingtian SHI
;
Haijie LIANG
;
Taiqiang YAN
;
Wei GUO
;
Rongli YANG
;
Xiaodong TANG
;
Xuemin ZHANG
Author Information
1. 北京大学人民医院骨与软组织肿瘤治疗中心 100044
- Keywords:
Bone neoplasms;
Postoperative complications;
Resuscitative endovascular balloon occlusion of the aorta;
Pelvic tumor;
Sacral tumor
- From:
Chinese Journal of Surgery
2021;59(9):737-743
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the causes,prevention and treatment of femoral artery puncture related complications caused by the application of resuscitative endovascular balloon occlusion of the aorta (REBOA) in the resection of pelvic and sacral tumors.Methods:Clinical data of 23 patients with femoral artery puncture related complications who received REBOA in the resection of pelvic and sacral tumors from August 2010 to August 2018 at the Musculoskeletal Tumor Center,Peking University People′s Hospital were retrospectively analyzed.There were 8 males and 15 females,with the age of (37.0±16.2) years (range:15 to 65 years).Arterial access via the Seldinger technique for REBOA was obtained in the right common femoral artery of 18 cases,and in the left of 6 cases.An arterial sheath with a diameter of 11 to 12 F(1 F≈0.33 mm) was used for the patient.The occurrence and treatment of postoperative complications were analyzed.Results:Acute femoral arterial thrombosis occurred in 18 patients,which was managed by open repair 48 hours postoperatively.Among the 349 patients admitted before 2015 who received hemostasis by compression after femoral artery sheath removal,12 patients (3.4%) developed acute femoral artery thrombosis.While the 476 patients admitted after 2015 who used a percutaneous suture device to close the femoral artery wound,6 patients (1.3%) developed acute femoral artery thrombosis.One case of retroperitoneal hematoma and 1 case of femoral pseudoaneurysm were found and surgically fixed.Postoperative follow-up was (40±18) months (range:13 to 108 months).Three cases with chronic lower extremity ischemia were confirmed by Doppler ultrasonography during 1 to 5 years follow-up.Two of them had minimal symptoms and denied further treatment,while the other one received femoral-femoral artery bypass surgery to restore distal flow for pain and numbness relief.Conclusions:Acute femoral arterial thrombosis is the most common femoral artery puncture.Technique refinement of REBOA,the use of percutaneous suture device and close follow-up can reduce the approach-specific complications,and help to detect and treat the complications timely,which may popularize the clinical application of REBOA.
