Turkish Neurosurgery 2018 , Vol 28 , Num 3
Iatrogenic Vascular Injuries Due to Spinal Surgeries: Endovascular Perspective
Mustafa GOK1,Elcin AYDIN2,Serkan GUNEYLI3,Ali AKAY4,Celal CINAR5,Ismail ORAN5
1Adnan Menderes University, Department of Radiology, Aydn, Turkey
2Baskent University, Department of Radiology, Izmir, Turkey
3Bulent Ecevit University, Department of Radiology, Zonguldak, Turkey
4Ege University, Department of Neurosurgery, Izmir, Turkey
5Ege University, Department of Radiology, Izmir, Turkey
DOI : 10.5137/1019-5149.JTN.19286-16.2 AIM: Iatrogenic vascular injuries due to spinal surgeries are rare but serious complications. Surgical management of these injuries is challenging with high morbidity rates. In this study we aim to present the results of endovascular management of iatrogenic vascular injuries due to spinal surgeries.

MATERIAL and METHODS: We retrospectively reviewed 11 patients (5 male, 6 female) who had vascular injuries due to cervical and lumbar spinal surgeries. Clinical findings were bleeding (n=5), leg edema (n=6) and right heart failure with severe dyspnea (n=1). The age range of the patients were between 42-67 (mean: 57.1). Six patients were reviewed with imaging before the procedures and the rest of the patients (n=5) were directly referred to the angiography unit for diagnosis and possible endovascular treatment.

RESULTS: The types of surgeries were; cervical surgery (n=5) and lumbar disc operation (n=6). The type of vascular injuries were; vertebral artery stenosis (n=1), vertebral artery pseudoaneurysm (n=3), vertebral artery occlusion (n=1) and iliac arteriovenous fistula (n=6). The type of endovascular treatments were; parent artery occlusion (PAO) (n=2), covered stent graft implantation (n=6) and intrasaccular coil embolization of pseudoaneurysm (n=1). The remaining 2 patients were managed conservatively. No major complications or mortality occured during endovascular interventions. No bleeding or ischemia occured in the follow-up period.

CONCLUSION: Iatrogenic vascular injuries due to spinal surgeries are rare but serious complications. Endovascular interventions are safe and effective in the diagnosis and treatment of such vascular injuries. Keywords : Iatrogenic vascular injury, Endovascular diagnosis, Endovascular treatment, Spinal surgery

Corresponding author : Mustafa GOK, mustafagok@yahoo.com