DOI: 10.2106/jbjs.cc.26.00150 ISSN: 2160-3251
Avoiding Vascular Misadventure: Pre-emptive Contralateral Endovascular Access in Revision Total Hip Arthroplasty
David Isaacs, Connor Byrne, Yun Ke Du, Douglas A. Troutman, Nathanael D. Heckmann, Neil P. ShethCase:
A 73-year-old woman with a custom triflange acetabular component (CTAC) underwent re-revision total hip arthroplasty (THA) with prophylactic contralateral vascular access. Severe acetabular bone loss led to medialization of the CTAC, putting the distal external iliac artery at risk during surgery. Endovascular access allowed for immediate control of hemorrhage if encountered. Patient was symptom-free at 1 year.
Conclusion:
This case demonstrates the feasibility and safety associated with obtaining pre-emptive vascular access for high-risk revision THAs. This methodology allows for potentially decreasing patients’ morbidity and mortality, without incurring significant additional risks.