Strategy to avoid vascular injuries in revision total hip arthroplasty with intrapelvic implants

• Autor(a) principal: Diesel, Cristiano Valter
• Data de Publicação: 2022
• Outros Autores: Guimarães, Marcelo Reuwsaat, Menegotto, Samuel Millán, Pereira, Adamastor Humberto, Pereira, Alexandre A., Bertolucci, Leonardo Henrique, Freitas, Eduarda Correa, Galia, Carlos Roberto
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFRGS
• Texto Completo: http://hdl.handle.net/10183/261872
• topic: Artroplastia de quadril; Próteses e implantes; Lesões do sistema vascular; Cirurgia; Hip; Hip arthroplasty; Intrapelvic implants; Vascular system injuries

Aims: Our objective was describing an algorithm to identify and prevent vascular injury in patients with intrapelvic components. Methods: Patients were defined as at risk to vascular injuries when components or cement migrated 5 mm or more beyond the ilioischial line in any of the pelvic incidences (anteroposterior and Judet view). In those patients, a serial investigation was initiated by a CT angiography, followed by a vascular surgeon evaluation. The investigation proceeded if necessary. The main goal was to assure a safe tissue plane between the hardware and the vessels. Results: In ten at-risk patients undergoing revision hip arthroplasty and submitted to our algorithm, six were recognized as being high risk to vascular injury during surgery. In those six high-risk patients, a preventive preoperative stent was implanted before the orthopaedic procedure. Four patients needed a second reinforcing stent to protect and to maintain the vessel anatomy deformed by the intrapelvic implants. Conclusion: The evaluation algorithm was useful to avoid blood vessels injury during revision total hip arthroplasty in high-risk patients.