Acute lower extremity paralysis after lower extremity endovascular intervention

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Urology

Background:

• Percutaneous revascularization is a common procedure for lower limb arterial disease.
• Stent implantation is frequently used to maintain vessel patency.
• Potential complications include bleeding and neurological deficits.

Observation:

• A 61-year-old male developed right lower limb paralysis post-procedure.
• Computed tomography (CT) revealed a distended bladder compressing iliac artery stent struts.
• This compression potentially affected the lumbosacral neural plexus.

Findings:

• Bladder distension, not hematoma, was the cause of neural compression.
• Urinary catheterization (Foley catheter) successfully decompressed the bladder.
• The patient experienced rapid neurological improvement after bladder decompression.

Implications:

• Bladder distension should be considered in the differential diagnosis of lower limb neurological deficits post-vascular procedures.
• Close collaboration between vascular surgery and urology is crucial for managing complex cases.
• This case highlights the importance of recognizing non-hemorrhagic causes of post-procedural complications.