Iliac Artery Ligation

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Abstract
To assess the effect of iliac artery ligation on the distal extremity, the 10 yr experience of the Johns Hopkins renal transplantation program was reviewed. Among 467 transplant procedures in 390 patients there were 6 cases in which the common and/or external iliac artery had been ligated for control of untoward hemorrhage from an infected arteriotomy site. These 6 cases were studied in detail with particular attention to ischemic sequelae in the involved leg. There were no immediate or causally-related deaths. No patient lost a leg or required an immediate reconstructive procedure for limb salvage. Of the 4 recovered ambulatory status and only 2 of these required a later, elective reconstruction for claudication. The combination of these 6 with 8 other similar patients previously reported provides a total of 14 cases of iliac artery ligation in renal transplant patients. No patient suffered actual limb loss and only 3 underwent subsquent elective reconstruction for claudication. Common and/or external iliac artery ligation without immediate revascularization may be performed for control of hemorrhage with little danger of limb loss in renal transplant patients.