Ligation or Occlusion of the Internal Iliac Arteries for the Treatment of Placenta Accreta Spectrum:Why Is This Technique Still Performed?

Introduction The major complication of placenta accreta spectrum(PAS)disorder is massive bleeding;therefore,multiple vascular interventions have been described to prevent or treat pelvic bleeding.Ligature of the internal iliac arteries(IIAs)was published more than 130 years ago,and although research relating to the physiology of this procedure has demonstrated poor vascular control over the last few decades,2-this technique has evolved into an established technique known as endovascular IIA balloon occlusion.

How to Reduce the Incidence of Placenta Accreta Spectrum Independently of the Number of Cesarean?

Placenta accreta spectrum(PAS)is growing worldwide,1 reaching epidemic proportions in many countries.There is not a simple and global solution to reduce the incidence of cesarean,because it is affecting by multifactorial problems.2 Although new,complete,and updated guides3-6 tried to cover all aspects in relation with the PAS,none of them has proposed a practical solution to stop this frightening disease.