Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Krakow, Poland.
Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Krakow, Poland.
World Neurosurg. 2020 May;137:111-118. doi: 10.1016/j.wneu.2020.01.168. Epub 2020 Feb 14.
Injury of the iliac vessels is a rare complication of lumbar spine surgery with potentially life-threatening consequences. We present 2 cases of iliac vessel injury that were treated with minimally invasive techniques.
The first case was a laceration of the common iliac artery during a simple L4-L5 discectomy in which the injured artery was secured by stent implantation. The second case was an example of injury to the left iliac common vessel leading to acute lower limb ischemia and arteriovenous fistula formation after lumbar spinal canal stenosis surgery. The patient was treated in 2 steps. First, a temporary femorofemoral bypass was implanted to revascularize the right lower limb. The second step involved stent implantation in the right common iliac artery to close the arteriovenous fistula. Both patients were treated without extensive laparotomy and had good clinical outcomes.
This case series emphasizes the benefit of quick minimally invasive vascular repair available in multidisciplinary centers.
髂血管损伤是腰椎手术的罕见并发症,可能导致危及生命的后果。我们报告了 2 例采用微创技术治疗的髂血管损伤病例。
第一例是在单纯 L4-L5 椎间盘切除术中发生的髂总动脉裂伤,通过支架植入术固定受伤的动脉。第二例是左髂总血管损伤导致腰椎管狭窄手术后急性下肢缺血和动静脉瘘形成的病例。该患者分两步治疗。首先,植入临时股-股旁路以重新建立右侧下肢的血运。第二步是在右髂总动脉植入支架以闭合动静脉瘘。两名患者均无需广泛剖腹手术,且临床结局良好。
本病例系列强调了多学科中心快速微创血管修复的益处。