Acetabular Screw in Close Proximity to the Posterior Branch of the Internal Iliac Artery in Revision Hip Surgery with Intrapelvic Migration of Acetabular Component: Preoperative Placement of a Fogarty Catheter in the Internal Iliac Artery (Case Report

Document Type : TECHNICAL NOTE

Authors

1 Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India

2 Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India

Abstract

Revision of an intrapelvic migration of the acetabular component of a total hip is a challenging surgery due to the 
risk of injury to the pelvic viscera. The primary concern is vascular injury due to the risk of mortality and limb loss. 
The researchers present one case where the acetabular screw was near the posterior branch of the internal iliac 
artery. A Fogarty catheter was placed in the internal iliac artery preoperatively, and the amount of fluid to inflate 
the catheter and completely block the artery was determined. The catheter was kept in a deflated condition. The 
hip reconstruction was performed, and there was no incidence of vascular injury during the procedure; hence, the 
Fogarty catheter was removed postsurgery. The placement of a Fogarty catheter in the at-risk vessel provides the 
freedom to proceed with the hip reconstruction through the standard approach. In case of an inadvertent event of 
a vascular injury, it can be inflated with the predetermined amount of saline to check the bleeding until the vascular 
surgeons take over the case. 
Level of evidence: V

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The Archives of Bone and Joint Surgery
Volume 11, Issue 1
January 2023
Pages 64-67

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History

  • Receive Date: 19 January 2022
  • Revise Date: 16 June 2022
  • Accept Date: 23 June 2022
  • First Publish Date: 30 December 2022

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