Endovascultar treatment of iliac vein perforation in pediatric patient using Amplatzer Vascular Plug

Sylvia K. Sánchez-González, 1Department of Paediatric Interventional Cardiology, Hospital del Niño Poblano, San Andrés Cholula, Pue., Puebla, México
José L. Colín-Ortiz, Department of Pediatric Cardiology, Instituto Nacional de Pediatría, Mexico City, Mexico
Alfredo Bobadilla-Aguirre, Department of Pediatric Cardiology, Instituto Nacional de Pediatría, Mexico City. Mexico

Latrogenic iliac vein perforation during pediatric cardiac catheterization is an uncommon but potentially life-threatening complication. We report the case of a 3-year-old boy with Down syndrome undergoing diagnostic cardiac catheterization for evaluation of pulmonary vascular resistance, who developed an external iliac vein perforation with retroperitoneal bleeding. The lesion was successfully treated using an endovascular approach with a 6-mm Amplatzer Vascular Plug II, which sealed the perforation. The vein subsequently drained through collateral circulation, and the patient remained asymptomatic over a 9-year follow-up. Endovascular occlusion using an Amplatzer plug may be a feasible option for managing iatrogenic iliac veinperforations in children.

Keywords: Iliac vein perforation. Iatrogenic venous injury. Retroperitoneal hemorrhage. Pediatric catheterization.