[Percutaneous placement of covered stents for treatment of post discectomy arterial rupture]

Vascular lesions produced as a consequence of surgical spinal treatment are rare, but serious. Fast diagnosis and treatment are essential in lesions that produce massive blood loss. Following the use of non covered stents in the treatment of peripheral vascular stenotic obstructive pathologies, the appearance of covered stents allowed aneurysms, pseudo aneurysms, fistulas or bleedings to be treated. Being able to graft a stent in serious patients, during diagnosis itself, with a minimum amount of aggression and local anaesthesia affords this technique huge advantages over others.

In this work we report the case of an arterial rupture which came about as a complication of a discectomy. After the surgical intervention, there was an important haematocrit reduction within a short space of time. The patient s quickly becoming anaemic and the existence of a retroperitoneal mass of heterogeneous echogenicity pointed towards a postoperative haemorrhage. This was confirmed by arteriography, which revealed an important contrast extravasation. A covered stent was placed at the same time and, in the post graft follow up, it was confirmed that there was no bleeding. At 12 hours after the operation the patient was moved from the postoperative recovery unit to a hospital ward and, 5 days later, was discharged. In a check up carried out in the Neurosurgery unit 2 months after being sent home, the patient was found to be asymptomatic.

The placement of covered stents is a valid therapeutic option for treating postoperative haemorrhagic lesions. It can be performed at the same time as diagnosis and does not require general anaesthesia. In the case we have described, the patient recovered quickly and ambulatory check ups showed he continued to be asymptomatic