Reduced bleeding through temporary balloon occlusion in hip and knee revision surgery

We used temporary balloon occlusion of the iliac or femoral artery to reduc e blood loss in major hip or knee operations in 15 cases in 13 patients. Th e balloon was introduced by an interventional radiologist in the afternoon of the day before surgery or in the morning before. A latex occlusion ballo on was inserted via the transfemoral ipsi- or contralateral route. The pati ents received two 40 mg doses of low molecular weight heparin. At the begin ning of the operation, saline was injected into the predetermined volume to inflate the balloon. The balloons were inflated during 1-6 hours. In each case, the balloon occlusion clearly reduced bleeding in the surgical field and facilitated surgery. The perioperative bleeding was reduced by half, as compared to a retrospective control group. We measured the intraarterial b lood pressures distally to the balloon in 2 patients. They decreased from 1 20 to 40 mm Hg and 155 to 50 mm Hg, respectively, after inflation. Two comp lications occurred, one bleeding due to catheter dislocation the night befo re surgery and one postoperative necrosis of the tip of a toe in a patient in whom the deflated balloon was not extruded until the day after surgery a nd the dose of heparin was too low.