title: Arterio-venous fistula following a lumbar disc surgery.
abstract: Vascular complications during posterior lumbar disc surgery are rare and its presentation with varicose veins is even rarer. A 23 year-old male patient presented with large varicose veins in right lower limb. He underwent a posterior lumbar spine discectomy surgery. He noticed mild swelling of the distal third right lower limb 3 months after index surgery and reported 6 months later when he developed varicose veins. Duplex Doppler confirmed varicose veins of the long saphenous vein and its tributaries with a patent deep venous system. A digital subtraction angiogram demonstrated a large right common iliac artery (CIA) false aneurysm with an arteriovenous fistula between right common iliac vessels. He had a right CIA covered stent insertion with good results. Varicose veins were later managed with sapheno-femoral junction ligation and a below knee long saphenous vein stripping. At six month follow-up the lower limb swelling had completely recovered and duplex ultrasound did not show any recurrence of varicose veins.
authors.affiliation: Medi-Clinic Unit of Peripheral Vascular Disease, Department of General Surgery, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa.
authors.forename: Thanyani V
authors.initials: TV
authors.lastname: Mulaudzi
authors.forename: Mbokeleng H
authors.initials: MH
authors.lastname: Sikhosana