Disección y trombosis de arteria iliaca común secundaria a traumatismo abdominal cerrado: tratamiento endovascular

Resumen

Introducción

Las lesiones traumáticas de las arterias iliacas son poco frecuentes, constituyen alrededor del 10% de todas las lesiones vasculares abdominales y se deben en su mayoría a traumatismos penetrantes. La mayoría de los casos documentados de lesiones iliacas por traumatismos contusos fueron tratados mediante técnicas convencionales. Presentamos un caso de lesión traumática cerrada de la arteria iliaca común resuelta mediante un abordaje mínimamente invasivo.

Caso clínico

Varón de 38 años que presenta traumatismo abdominal cerrado tras accidente laboral, con lesiones óseas y abdominales asociadas a disección y trombosis de la arteria iliaca común derecha, que se trata mediante trombectomía e implantación de un stent autoexpandible de nitinol. El control realizado con eco-Doppler a los tres meses demostró la permeabilidad del stent y el eje iliaco tratado.

Conclusión

El tratamiento endovascular de lesiones arteriales iliacas secundarias a traumatismos cerrados es una opción válida y debe considerarse particularmente en pacientes politraumatizados con múltiples lesiones, en los que la cirugía abierta se asocia a elevadas tasas de morbimorta-lidad.

Summary

Introduction

Traumatic injuries to the iliac arteries are infrequent; they account for about 10% of all injuries to abdominal blood vessels and are mainly due to stab wounds. Most of the cases of iliac injury caused by blunt trauma that have been described to date were treated using conventional techniques. We report a case of closed traumatic injury to the common iliac artery that was resolved by a minimally invasive approach.

Case report

We describe the case of a 38-year-old male who presented a closed abdominal trauma as a result of a work accident, with bone and abdominal injuries associated to dissection and thrombosis of the right common iliac artery, which was treated by means of a thrombectomy and placement of a self-expanding nitinol stent. A control Doppler ultrasound scan performed at three months showed that the stent was patent and the iliac axis had been treated.

Conclusions

Endovascular treatment of injuries to the iliac artery secondary to closed trauma is a valid option and should be taken into account particularly in the case of patients with multiple traumatic injuries, in whom open surgery is associated to high morbidity and mortality rates.