Arteriovenous fistula after intervertebral disk surgery at L4-L5

Area of Science:

• Vascular Surgery
• Cardiology
• Neurosurgery

Background:

• Arteriovenous fistulas (AVFs) are abnormal connections between arteries and veins.
• Iatrogenic AVFs can occur after surgical procedures.
• Right iliac artery to inferior vena cava fistulas are uncommon but can lead to significant complications like heart failure.

Purpose of the Study:

• To report a case of heart failure secondary to an iatrogenic arteriovenous fistula.
• To review the literature on managing such fistulas.
• To highlight the successful endovascular treatment of this specific AVF.

Main Methods:

• A 34-year-old female patient presented with symptoms of heart failure.
• Diagnostic imaging confirmed an arteriovenous fistula between the right iliac artery and the inferior vena cava, attributed to prior herniated intervertebral disk surgery.
• The fistula was successfully treated using an intra-arterial placed covered stent.

Main Results:

• The patient's heart failure symptoms resolved post-intervention.
• The covered stent provided a durable seal, excluding the fistula.
• No immediate complications were reported following the endovascular procedure.

Conclusions:

• Iatrogenic arteriovenous fistulas, though rare, can present with severe hemodynamic consequences.
• Endovascular repair using covered stents is a viable and effective treatment option.
• Multidisciplinary management is crucial for optimal outcomes in complex vascular injuries.