1
|
Successful Endovascular Surgery for Iatrogenic Common Iliac Artery Injury during Lumbar Spine Surgery: A Case Report. Medicina (B Aires) 2022; 58:medicina58070927. [PMID: 35888646 PMCID: PMC9323261 DOI: 10.3390/medicina58070927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/24/2022] [Accepted: 07/09/2022] [Indexed: 11/17/2022] Open
Abstract
An 80-year-old man was admitted with an L5 compression fracture, L4/5 spondylolisthesis, and L5 radiculopathy and underwent a TLIF procedure. Refractory hypotension occurred, though it indicated a possible great vessel injury with vasopressor and fluid infusion. Emergent intraoperative angiography was performed, which showed extravasation at the right common iliac artery. Resuscitative endovascular balloon occlusion of the aorta followed by right common iliac artery stenting was successfully performed to arrest the bleeding. The iatrogenic right common iliac artery laceration was complicated with abdomen compartment syndrome and acute kidney injury. The patient received supportive care, including continuous venovenous hemofiltration (CVVH) for a week, after which the patient’s condition improved. The patient did not have any residual complications at the one-month follow-up. Great vessel injury during the TLIF procedure is rare but fatal. Refractory hypotension is indicative of a great vessel injury. Endovascular intervention is a fast and promising method to diagnose and treat arterial injury.
Collapse
|
2
|
Yan GW, Li HW, Yang GQ, Bhetuwal A, Liu JP, Li Y, Fu QS, Zhao LW, Chen H, Hu N, Wu L, Yan J, Wang W, Shuang JY, Ge J. Iatrogenic arteriovenous fistula of the iliac artery after lumbar discectomy surgery: a systematic review of the last 18 years. Quant Imaging Med Surg 2019; 9:1163-1175. [PMID: 31367570 DOI: 10.21037/qims.2019.05.12] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Patients with iatrogenic iliac arteriovenous fistulas (IAVFs) after lumbar discectomy surgeries (LDSs) from our hospital and the published literature were reviewed in order to better understand this clinical phenomenon. Literature from databases about iatrogenic IAVFs after LDSs were retrieved and a patient from our hospital was reviewed with emphasis placed upon the patient's clinical data. From 31 publications and studies of 44 individuals' data, the study revealed L4-L5 and/or L5-S1 intervertebral space levels were mostly involved (62.0%). Most of the patients underwent computed tomography angiography (CTA) and/or digital subtraction angiography (DSA) examinations to confirm the potential diagnosis and rule out other differential diagnosis (86.4%). Most of the patients (63.6%) developed features of high output heart failure months to years after the LDSs, and the majority of them (88.6%) were treated with endovascular repairs. An iatrogenic IAVF after an LDS is a rare occurrence; however, more attention should be paid to it for the purpose of obtaining accurate diagnosis and proper treatment.
Collapse
Affiliation(s)
- Gao-Wu Yan
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Hong-Wei Li
- Department of Radiology, The Third Hospital of Mianyang (Sichuan Mental Health Center), Mianyang 621000, China
| | - Guo-Qing Yang
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Anup Bhetuwal
- Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
| | - Jian-Ping Liu
- Department of Cardiovascular Surgery, Suining Central Hospital, Suining 629000, China
| | - Yong Li
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Quan-Shui Fu
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Lin-Wei Zhao
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Hong Chen
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Na Hu
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Lei Wu
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Jing Yan
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Wei Wang
- Department of Radiology, Suining Central Hospital, Suining 629000, China
| | - Jiao-Yue Shuang
- Department of Radiology, Suining Central Hospital, Suining 629000, China.,Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
| | - Jing Ge
- Department of Cardiovascular Surgery, Suining Central Hospital, Suining 629000, China
| |
Collapse
|
3
|
Bae HJ, Cho TG, Kim CH, Lee HK, Moon JG, Choi JI. Aortic Injury during Transforaminal Lumbar Interbody Fusion. KOREAN JOURNAL OF SPINE 2017; 14:118-120. [PMID: 29017312 PMCID: PMC5642096 DOI: 10.14245/kjs.2017.14.3.118] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 07/14/2017] [Accepted: 08/21/2017] [Indexed: 11/29/2022]
Abstract
Aortic injury during transforaminal lumbar interbody fusion (TLIF) is a rare but severe complication. We experienced aortic injury during TLIF at L3–4 with a 59-year-old woman diagnosed with an adjacent segment disease at L3–4. Severe bleeding occurred during disc space expansion, and the blood pressure dropped to 60/40 mmHg. The patient’s vital sign stabilized after compression with gauze and Gelfoam in addition to blood transfusion. The patient was treated with endovascular repair using a percutaneous technique after intertransverse fusion at L3–4 was completed. She recovered and is being followed-up in the outpatient department.
Collapse
Affiliation(s)
- Hee Jin Bae
- Department of Neurosurgery, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Tack Geun Cho
- Department of Neurosurgery, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Chang Hyun Kim
- Department of Neurosurgery, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Ho Kook Lee
- Department of Neurosurgery, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Jae Gon Moon
- Department of Neurosurgery, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Jong Il Choi
- Department of Neurosurgery, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| |
Collapse
|