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Eur Spine J (2008) 17 (Suppl 2):S228S231 DOI 10.1007/s00586-007-0470-3
CASE REPORT
Endovascular repair of iliac artery injury complicating lumbar disc surgery
P. Skippage J. Raja R. McFarland A. M. Belli
Received: 30 January 2007 / Revised: 11 July 2007 / Accepted: 27 July 2007 / Published online: 22 August 2007 Springer-Verlag 2007
Abstract Vascular injury as a complication of disc surgery was rst reported in 1945 by Linton and White. It is a rare but potentially fatal complication. The high mortality rate (40100%) is attributed to a combination of rapid blood loss and the failure to recognise the cause of the deteriorating patient. Early diagnosis and treatment is essential. Treatment has traditionally been by open vascular surgical repair, however with modern imaging and endovascular techniques, minimally invasive treatment should be considered rst line in patients who are stable. We present the case of a 51-year-old woman who sustained common iliac artery injury during lumbar spinal surgery that was treated successfully using a covered stent.
Keywords Iliac artery Endovascular repair
Covered stent Disc surgery
Introduction
Vascular injury as a complication of disc surgery was rst reported in 1945 by Linton and White [7]. It is a rare complication. However, the true incidence of occurrence is uncertain, as many injuries go undetected clinically. Yu-Ling Hui et al. postulate that up to 2.4% of lumbar laminectomies
may be complicated by vascular injury [6]. When clinically apparent that vascular injury has occurred, the mortality is quoted at 40100% [5, 10]. The high mortality rate is attributed to a combination of rapid blood loss into the retroperitoneal and intraperitoneal spaces, and the failure to recognise the cause of the deteriorating patient. Early diagnosis and treatment is essential due to the high rates of associated mortality and morbidity [3]. Treatment has traditionally been by open vascular surgical repair, however with modern imaging and endovascular techniques, minimally invasive treatment is a therapeutic option.
We present the case of a 51-year-old woman who sustained common iliac artery injury during lumbar spinal surgery that was diagnosed by computed tomography and treated by percutaneous placement of a covered stent.
Case report
A 51-year-old woman was admitted for an L5/S1 stabilisation procedure and L5 nerve root decompression following failure of an L4/5 discectomy 4 months previously...