Abstract
Traumatic lumbar artery injuries are quite uncommon, and arteriovenous fistula (AVF) lesions are also rare. The clinical symptoms associated with AVF of the lumbar artery are often vague and non-specific and can be masked by symptoms due to the spinal cord injury. Therefore, AVF of the lumbar artery can often be missed if the performance of a contrast-enhanced computed tomography (CECT) scan is absent. In this article, we portrait a case of post-traumatic lumbar artery AVF along with pseudoaneurysm in a 40-year-old who suffered from pain in the right lumbar region. After endovascular intervention therapy for one month, the Visual Analogue Scale (VAS) was 1 in comparison with 8 prior to treatment. Thus, an endovascular intervention should be considered an effective treatment option for AVF and pseudoaneurysm of the LA.
Highlights
Injury to the lumbar artery (LA) can occasionally lead to life-threatening retroperitoneal hemorrhage 1
Arteriovenous fistula (AVF) lesions are extremely rare, some reports indicate that AVF represents a late complication caused by the erosion and rupture of a pseudoaneurysm into adjacent veins, such as the inferior vena cava (IVC) or the iliac veins
Upon conducting a digital subtraction angiography (DSA), the lesion was clearly shown to be a pseudoaneurysm of the L4 LA, sized approximately 60 mm × 40 mm, with a fistula connecting to the IVC (Figure 2)
Summary
Injury to the lumbar artery (LA) can occasionally lead to life-threatening retroperitoneal hemorrhage 1. Arteriovenous fistula (AVF) lesions are extremely rare, some reports indicate that AVF represents a late complication caused by the erosion and rupture of a pseudoaneurysm into adjacent veins, such as the inferior vena cava (IVC) or the iliac veins. We present a clinical case of pseudoaneurysm with AVF of the LA that was successfully embolized. Two years after the surgery, the patient experienced pain in the right lumbar region with a VAS of 8 that lasted for one month. Upon conducting a digital subtraction angiography (DSA), the lesion was clearly shown to be a pseudoaneurysm of the L4 LA, sized approximately 60 mm × 40 mm, with a fistula connecting to the IVC (Figure 2). A Rare Case of Pseudoaneurysm and an Arteriovenous Fistula of the Lumbar Artery Treated by Endovascular Intervention. One-month post-treatment, the VAS was 1 with a reduction rate of 87.5%
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