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CASE REPORTS
JOURNAL ARTICLE
Lumbar Arterial Bleeding Treated with Endovascular Aneurysm Repair: A Report of 4 Patients.
Annals of Vascular Surgery 2018 May
BACKGROUND: Lumbar arterial bleeding is a severe condition. Surgical exploration is not indicated because of its rich collateral flow. Transarterial embolization (TAE) is reportedly effective, but there have been cases of failure. It may be a time-consuming procedure for patients with multiple bleeding sources or those with poor vital signs. In this case series, we used endovascular aneurysm repair (EVAR) instead of TAE.
METHOD: In this case series, we described 4 male patients (2 with traumatic injury, 1 with iatrogenic injury, and 1 with drug-induced hypocoagulability) with lumbar arterial bleeding. The reasons we chose EVAR are because 2 patients had poor vital signs, one patient was a technically difficult case for selective cannulation, and one patient had accompanying aortic dissection.
RESULT: In all patients, EVAR was performed successfully, and hemostasis was obtained although one patient died of pneumonia on postoperative day 23.
CONCLUSIONS: EVAR is an effective alternative for lumbar arterial bleeding although TAE is a first choice of treatment.
METHOD: In this case series, we described 4 male patients (2 with traumatic injury, 1 with iatrogenic injury, and 1 with drug-induced hypocoagulability) with lumbar arterial bleeding. The reasons we chose EVAR are because 2 patients had poor vital signs, one patient was a technically difficult case for selective cannulation, and one patient had accompanying aortic dissection.
RESULT: In all patients, EVAR was performed successfully, and hemostasis was obtained although one patient died of pneumonia on postoperative day 23.
CONCLUSIONS: EVAR is an effective alternative for lumbar arterial bleeding although TAE is a first choice of treatment.
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