Case: A 72-year-old morbidly obese nonambulatory woman with bilateral chronically infected revision knee prostheses and incompetent extensor mechanisms who uses a wheelchair had limited functionality and presented with recalcitrant chronic infection with multiple hospitalizations. The patient underwent staged bilateral above-knee amputations. The first procedure caused extensive morbidity secondary to poor vascular control. For the second surgery, collaboration with vascular surgery was used to achieve endovascular control of the external iliac artery with improved postoperative course.

Conclusions: Endovascular balloon occlusion may be an effective adjunct to customary hemostasis modalities during above-knee amputations in morbidly obese patients.

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http://dx.doi.org/10.2106/JBJS.CC.19.00024DOI Listing

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