Considerations for Iliac Vein Repair in the Setting of Urologic Procedures

Iliac vein injuries are associated with high morbidity and mortality, with a feared complication of hemorrhage. We discuss management and the thought process behind mitigating such emergencies. An 81-year-old Caucasian male was seen intraoperatively by Vascular Surgery for hemorrhage from an injured left external iliac vein (LEIV) in the setting of left radical nephrectomy and ureterectomy. Despite initial temporizing efforts by Urology, Vascular Surgical intervention proved necessary in hemostasis, venous reconstruction and thus, establishing continuity of lower extremity venous drainage.