Iliac Artery Laceration Secondary to Retained Femoral Artery Sheath

Abstract

Four patients required surgery to control bleeding from an iliac artery laceration. All patients had an 8 Fr or larger femoral artery sheath left within the iliac artery system for at least 8 hours. Symptoms included lower back or abdominal pain. Patients were taken emergently to the surgical suite for control of their bleeding episode. The bleeding was occurring from a laceration of the iliac artery wall at its bifurcation into the external and internal iliac arteries, which appeared to have resulted from the tip of the retained sheath. All patients had recently received heparin or urokinase. Primary repair was possible in three patients; another required an ileoileo bypass graft. Despite successful repair of the vessel, one patient died. Retained femoral artery sheaths can lead to lacerations of the iliac artery. The length of time that sheaths are left in the artery should be minimized to prevent laceration of the arterial wall by the tip of the sheath.