Strategic Surgical Management of Idiopathic Iliac Vein Rupture: A Case Report Emphasizing Preoperative IVC Filter and Distal Venous Control.

Idiopathic iliac vein rupture (IIVR) is a rare, life-threatening condition. We report a successful case of a 66-year-old woman with hemorrhagic shock and disseminated intravascular coagulation managed with a strategic surgical approach. To prevent intraoperative pulmonary embolism from extensive deep vein thrombosis, a temporary inferior vena cava filter was placed. Distal venous control was achieved via a femoral vein clamp through a separate inguinal incision prior to pelvic exploration. Primary suture repair combined with thrombectomy successfully preserved venous outflow. This multistep strategy is effective for managing IIVR, ensuring hemodynamic stability and preventing fatal embolic complications.