[Thrombosis of an aorto-iliac stent graft used for treating an iliocaval arteriovenous fistula following lumbar disc surgery]

Abstract

Objectives: Major vessel injury is a rare complication of spinal surgery. Iliac artery injury is the most common. Frequently, a chronic arteriovenous fistula develops.

Methods: We describe the case of a 63-year-old woman who had developed a chronic arteriovenous fistula following lumbar disc hernia surgery. The patient was treated using an Anaconda™ stent graft (Vascutek Terumo). After 2years, the prothesis thrombosed and an aorto-iliac bypass was performed.

Results: A gel soft prosthesis 18/9 (Vascutek Terumo) was implanted by laparotomy. The postoperative period was uneventful. A month later, the patient had recovered good lower limb function.

Conclusion: The choice between endovascular versus open surgery must take into account the patient's age, the risk of long-term complications, and the need for radiographic surveillance. Curative open surgery remains a valid option for young patients.

Keywords: Arteriovenous fistula; Chirurgie discale lombaire; Endoprothèse; Fistule artério-veineuse; Iatrogenic; Iatrogènie; Spinal surgery; Stent graft; Thrombose; Thrombosis.