http://www.healio.com/journals/ORTHO/%7B6BE885F9-FCD6-47F3-9D65-9520B44F5B4E%7D/Deep-External-Pudendal-Artery-Injury-After-Percutaneous-Adductor-Tenotomy-During-THA-in-Ankylosing-SpondylitisDeep External Pudendal Artery Injury After Percutaneous Ankylosing Spondylitis
Arterial injuries following total hip arthroplasty (THA) are uncommon and are usually related to revision THA. Deep external pudendal artery injury and delayed bleeding due to percutaneous adductor tenotomy during THA has not been reported." (more...)
Massive uncontrolled arterial bleeding complicating THA requires urgent operative repair or embolization.5,7,11 However, embolization seems to have significant advantages over open procedures, such as avoidance of general anesthesia, minor trauma, better location, and control of bleeding maintaining satisfactory hematocrit levels.10,11,17,18 In our patient, echo-guided compression was attempted to stop the hemorrhage but provided no benefit; the hematoma remained circulating. Superselective embolization of the external pudendal artery with the use of 2 endovascular coils was successful. Unlike the standard selective procedure, the superselective technique allows preservation of the blood supply from the uninjured arterial branches.
The deep external pudendal artery may be injured during percutaneous adductor tenotomy, especially in patients with fragile arterial walls, and life-threatening complications may occur. Angiography and embolization are the best treatment options."
Interesting paper - carries illustrations