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Endovascular Repair of Aorto-iliac Artery Injuries after Lumbar-spine Surgery

2011; Elsevier BV; Volume: 42; Issue: 2 Linguagem: Inglês

10.1016/j.ejvs.2011.04.011

1532-2165

Ludovic Canaud, Kheira Hireche, Frédéric Joyeux, T. D’Annoville, Jean‐Philippe Berthet, Charles Marty‐Ané, Pierre Alric,

Aortic Disease and Treatment Approaches

Abstract Objective This study aims to describe the endovascular management of abdominal-aortic- or common-iliac-artery injuries after lumbar-spine surgery. Methods Patients treated for abdominal-aortic- or common-iliac-artery injuries after lumbar-spine surgery during a 13-year period were identified from an endovascular database, providing prospective information on techniques and outcome. The corresponding patient records and radiographic reports were analysed retrospectively. Results Seven patients were treated with acute ( n = 3) or subacute ( n = 4) injuries of the common iliac artery ( n = 6) or abdominal aorta ( n = 1) after lumbar-spine surgery. Vascular injuries included arterial lacerations ( n = 3), arteriovenous fistulas ( n = 2) and pseudo-aneurysms ( n = 2). The mean age of the patients was 51.7 years (30–60 years), 71.4% were women. These lesions were repaired by transluminal placement of stent grafts: Passager ( n = 3), Viabahn ( n = 1), Wallgraft ( n = 1), Zénith ( n = 1) and Advanta V12 ( n = 1). Exclusion of the injury was achieved in all cases. Mortality was nil. There were no procedure-related complications. During a median follow-up of 8.7 years (range 0.3–13 years), all stent grafts remained patent. Conclusions Sealing of common iliac artery or abdominal aortic lesions as a complication of lumbar-disc surgery with a stent graft is effective and is suggested as an excellent alternative to open surgery for iatrogenic great-vessel injuries, particularly in critical conditions.