title: Emergency stenting to control massive bleeding of injured iliac artery following lumbar disk surgery.
abstract: The purpose of this study was to demonstrate the use of endovascular stenting to repair an iliac artery injury following lumbar discectomy, thus obviating the need for major surgery. A 57-year-old woman developed a distended abdomen and signs of hypovolemic shock immediately following discectomy at the L4-L5 level. Ultrasound showed a large amount of abdominal fluid. Angiography revealed a laceration of the right iliac artery bifurcation with extravasation of contrast material. After occlusion of the internal iliac artery with fibered coils to prevent retrograde flow to the iliac bifurcation, a self-expanding covered stent was inserted to seal the iliac laceration. The leakage of blood stopped immediately. The clinical condition of the patient gradually improved and she was discharged home 5 weeks later. Sealing of arterial laceration as a complication of lumbar disc surgery with a covered stent is a simple and effective alternative to major pelvic surgery.
authors.affiliation: Department of Radiology, St. Elisabeth Ziekenhuis, Hilvarenbeekseweg 60, 5022 GC, Tilburg, The Netherlands.
authors.forename: Edwin
authors.initials: E
authors.lastname: Bierdrager
authors.forename: Willem Jan
authors.initials: WJ
authors.lastname: Van Rooij
authors.forename: Menno
authors.initials: M
authors.lastname: Sluzewski
mesh_terms: D017130:Angioplasty; D017586:Diskectomy / Q000009:adverse effects*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000293:injuries*; D007405:Intervertebral Disc Displacement / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000628:therapy*; D015607:Stents