Endovascular Stenting of External Iliac Vein Injury during Anterior Spine Exposure

Abstract

Anterior lumbar interbody fusion (ALIF) is a standard approach for the surgical management of patients with severe degenerative disease at the lumbar 4-5 (L4-L5) and lumbosacral (L5-S1) levels. ALIF is performed through a retroperitoneal exposure but harbors a small risk of major vascular injury. In this case, we describe an emergent endovascular repair of an external iliac vein injury that occurred during ALIF with long-term follow-up. We discuss specific strategies in the decision making and technique that led to a successful outcome in this case. Endovascular stent-grafting is a potential bail-out option for serious iliac vein injury.