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Iliac arteriovenous fistula following lumbar disc surgery. A case report
H Naouli1, H Jiber1, A Bouarhroum1
1Faculty of medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University Boite Postale 1893 - KM 2.200, route Sidi Harazem Fès, 30070 Morocco; Vascular surgery department, UHC Hassan II Fez, Morocco.
Insights
A rare complication of lumbar disc surgery, an iliac arteriovenous fistula, can cause heart failure. Surgical repair of this fistula effectively resolved the patient's symptoms, demonstrating a successful treatment outcome.
Area of Science:
- Vascular Surgery
- Neurosurgery
- Cardiology
Background:
- Iliac arteriovenous (AV) fistulas are rare complications following lumbar disc surgery.
- Delayed presentation of symptoms, such as congestive heart failure, can occur years after the initial spinal procedure.
Observation:
- A 44-year-old male presented with congestive heart failure symptoms four years after an L4-L5 spinal discectomy.
- Computed tomography angiography (CTA) confirmed a right common iliac artery and vein fistula.
Findings:
- The arteriovenous fistula was successfully closed using lateral suturing of the common iliac artery and vein.
- The surgical intervention was performed via a transperitoneal aorto-iliac approach.
Implications:
- This case highlights the importance of considering rare vascular complications after spinal surgery in patients with unexplained heart failure.
- Successful surgical management of iliac AV fistulas can lead to complete resolution of symptoms and long-term recovery.
Abstract:
Iliac arteriovenous (AV) fistula after lumbar disc surgery are uncommon entities with limited reported cases. This report describes a 44-year-old man with history of L4-L5 spinal discectomy who complained of congestive heart failure symptoms four years later. Computed tomography angiography (CTA) revealed an AV fistula connecting the right common iliac artery and vein. AV closure with lateral suturing of common iliac artery and vein was performed through transperitoneal aorto-iliac approach. Postoperatively, the patient's symptoms of orthopnea resolved. Follow-up at six years was uneventful.
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