title: Alternative management of iliac vein injury during anterior lumbar spine exposure.
abstract: Vascular injuries are, unfortunately, common complications during anterior approach to lumbar spine, with venous injuries occurring most frequently. The L4-L5 level of exposure is associated most commonly with venous injuries because it requires significant mobilization of the vascular structures. We present two cases of left common iliac vein tears encountered during redo anterior exposure for spine revision. This was in the setting of an anterior lumbar interbody fusion at the L4-L5 level and for the repeat disc arthroplasty at the L5-S1 level. We describe the endovascular technique used to successfully repair venous tear with the deployment of a covered stent across the injury, preventing the ligation of the left common iliac vein.
authors.affiliation: Department of Vascular Surgery, The Cleveland Clinic, Cleveland, OH 44195, USA. vzahradnik@gmail.com
authors.forename: Vladimir
authors.initials: V
authors.lastname: Zahradnik
authors.forename: Vikram S
authors.initials: VS
authors.lastname: Kashyap
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D057510:Endovascular Procedures / Q000295:instrumentation; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging / Q000293:injuries*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D010690:Phlebography; D011474:Prosthesis Design; D013123:Spinal Fusion / Q000009:adverse effects*; D015607:Stents; D059145:Total Disc Replacement / Q000009:adverse effects*; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*