J Korean Radiol Soc.  2007 Jul;57(1):15-20. 10.3348/jkrs.2007.57.1.15.

Diagnosis of Arteriovenous Fistulas following a Lumbar Discectomy

• Roh BS
• Choi MY
• Jean SJ
• Park SH
• Kim HW
• Kim JH

• KMID: 1834475
• DOI: http://doi.org/10.3348/jkrs.2007.57.1.15

Abstract

PURPOSE
To evaluate the relevant clinical and radiographical findings for the diagnosis of an arteriovenous fistula after a lumbar discectomy.
MATERIALS AND METHODS
Five patients with an arteriovenous fistula following a lumbar discectomy were preoperatively diagnosed and treated. We retrospectively evaluated the level of surgery, injured vessels, clinical symptoms, physical findings, and the interval between surgery and treatment. Effective and fast diagnostic methods for determining the presence of a postoperative arteriovenous fistula were evaluated.
RESULTS
All of the arteriovenous fistulas resulted from operative injuries of the iliac arteries and veins. They were diagnosed after a mean time of 22 months (range 2 months-4 years) in spite of various symptoms and signs shortly after surgery. The arteriovenous fistulas were confirmed with angiography and were treated by surgery for 3 patients and by insertion of a stent-graft in 2 patients. Postoperative CT angiography showed the complete occlusion of the fistula tract and the normal blood flow.
CONCLUSION
Essential clinical information and radiological examination, especially CT angiography with 3D reconstruction, is necessary to obtain to diagnose an arteriovenous fistula after a lumbar discectomy.

Keyword

Fistula, arteriovenous; Spine, surgery; Computed tomography (CT), angiography; Stents and prostheses

MeSH Terms

Angiography
Arteriovenous Fistula*
Diagnosis*
Diskectomy*
Fistula
Humans
Iliac Artery
Retrospective Studies
Veins