Postlaminectomy arteriovenous fistula: the Brazilian experience

Arteriovenous fistula is an infrequent complication of lumbar disc surgery. It is often not suspected, and the symptoms are diagnosed as deep venous thrombosis or heart failure. As a result of our review of the Brazilian literature and a survey of 3,500 Brazilian physicians, 5 cases of post-laminectomy arteriovenous fistula are added to the literature. A review of these cases shows that: (1) the right common iliac artery was injured in most cases, (2) the vena cava was frequently injured, and (3) direct repair was possible when the vena cava and the aorta were injured. A vascular prosthesis was necessary when the iliac arteries were damaged. The correct diagnosis is usually made by detection of an abdominal bruit in a patient with a history of lumbar disc surgery and is confirmed by arteriogram. Surgical treatment, either by suture or bypass, is the treatment of choice and results in cure.