Internal iliac artery ligation (IIAL) is a surgical procedure performed to reduce pelvic blood flow. It is most commonly employed in situations where there is life-threatening pelvic hemorrhage, particularly obstetric and gynecologic emergencies, such as postpartum hemorrhage (PPH), trauma, or pelvic surgeries.By ligating the internal iliac artery, the arterial blood flow to the pelvis is reduced, thereby diminishing the pressure in the smaller arteries and capillaries supplying the pelvic organs. This helps to slow or stop hemorrhage while preserving blood flow via collateral circulation, especially from the external iliac artery and other surrounding vessels. The uterus and pelvic organs still receive blood from other arterial sources, reducing the risk of tissue ischemia.The procedure is often performed via laparotomy but can be done laparoscopically.
IN trauma surgery, vessel loops or tapes along with vascular clamps or Rummel tourniquets have been used for temporary reduction of internal iliac blood flow and then released subsequent to control of distal hemorrhage
