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Left Iliac Artery Thrombosis during Anterior Lumbar Surgery

  • Papers Presented to the Southern California Vascular Surgical Society
  • Published:
Annals of Vascular Surgery

Abstract

To determine the incidence of left iliac artery thrombosis (LIAT), a prospective database was maintained on 1315 patients undergoing anterior lumbar surgery (ALS) between August 1997 and December 2002. All had distal pulse evaluation preoperatively. In the last 629 cases pulse oxymetry was used to monitor the distal circulation during and after surgery. Patients with pulse deficits or evidence of ischemia after surgery were further analyzed. Six patients were identified with LIAT (0.45%). Five were females and one was male, with ages ranging from 35 to 56 years. All had exposure at the L4-5. Five were diagnosed at surgery and one in the recovery room after posterior surgery. All except one had strong, palpable preoperative pulses. Pulse oxymetry confirmed the diagnosis in two patients, in whom it was not clinically evident. Four had successful thrombectomy; one had a femoro-femoral bypass and one had an axillo-femoral bypass. Two developed compartment syndrome. None had calcifications on preoperative X-rays. LIAT is an uncommon complication of ALS. Early identification and management can avoid long-term complications. Pulse oxymetry helps in its timely identification. Patients undergoing exposure at L4-5 and females are at greater risk.

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Authors and Affiliations

  1. Spine Access Surgery Associates, Los Angeles, CA, USA

    Salvador A. Brau MD

  2. Department of Surgery, UCLA School of Medicine, Los Angeles, CA, USA

    Salvador A. Brau MD

  3. The Spine Institute at Saint John’s Hospital, Department of Orthopedics, UCLA School of Medicine, Santa Monica, CA, USA

    Rick B. Delamarter MD

  4. Southern California Orthopedic Professionals, Los Angeles, CA, USA

    Michael L. Schiffman MD

  5. Los Angeles Spine Surgery Institute, Department of Surgery, Keck School of Medicine at University of Southern California, Los Angeles, CA , USA

    Lytton A. Williams MD & Robert G. Watkins MD

Authors
  1. Salvador A. Brau MD
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  2. Rick B. Delamarter MD
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  3. Michael L. Schiffman MD
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  4. Lytton A. Williams MD
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  5. Robert G. Watkins MD
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Corresponding author

Correspondence to Salvador A. Brau MD.

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Brau, S.A., Delamarter, R.B., Schiffman, M.L. et al. Left Iliac Artery Thrombosis during Anterior Lumbar Surgery. Ann Vasc Surg 18, 48–51 (2004). https://doi.org/10.1007/s10016-003-0104-0

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  • DOI: https://doi.org/10.1007/s10016-003-0104-0

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