Intraspinal Iliac Venous Stent Migration with Lumbar Nerve Root Compression.


Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
05 2020
Historique:
received: 10 11 2019
revised: 03 02 2020
accepted: 04 02 2020
pubmed: 15 2 2020
medline: 29 7 2020
entrez: 15 2 2020
Statut: ppublish

Résumé

Venous stenting is a common treatment for chronic peripheral venous disease. The most frequent complications caused by this technique are stent misplacement and intracardiac or intravascular stent migration. In this publication, we will describe the first case of an intraspinal stent misplacement leading to lumbar nerve root compression. Our patient was a 20-year-old woman with a bilateral pulmonary embolism caused by a right common iliac vein thrombosis and a severe compression of the left common iliac vein by the right common iliac artery (May-Thurner or Cockett syndrome). She underwent an endovascular stenting of the left iliac vein. A few days later, she reported some pain in the right L5 radicular and showed signs of hypoesthesia of the left leg and of paresis of the left extensor hallucis longus muscle. A lumbar computed tomography scan showed a stent misplacement into the spinal canal through the left L5 foramen with nerve root compression. She underwent a surgical removal of the stent through a unilateral L5-S1 laminarthrectomy. The postoperative follow-up showed a complete clinical recovery and a control lumbar computed tomography scan confirmed the L5 nerve root decompression. The intraspinal misplacement of a venous stent is a rare complication that may cause nerve root injury. It requires a prompt treatment. Surgically removing the stent by a posterior approach seems to be a simple and safe therapeutic option.

Sections du résumé

BACKGROUND
Venous stenting is a common treatment for chronic peripheral venous disease. The most frequent complications caused by this technique are stent misplacement and intracardiac or intravascular stent migration. In this publication, we will describe the first case of an intraspinal stent misplacement leading to lumbar nerve root compression.
CASE DESCRIPTION
Our patient was a 20-year-old woman with a bilateral pulmonary embolism caused by a right common iliac vein thrombosis and a severe compression of the left common iliac vein by the right common iliac artery (May-Thurner or Cockett syndrome). She underwent an endovascular stenting of the left iliac vein. A few days later, she reported some pain in the right L5 radicular and showed signs of hypoesthesia of the left leg and of paresis of the left extensor hallucis longus muscle. A lumbar computed tomography scan showed a stent misplacement into the spinal canal through the left L5 foramen with nerve root compression. She underwent a surgical removal of the stent through a unilateral L5-S1 laminarthrectomy. The postoperative follow-up showed a complete clinical recovery and a control lumbar computed tomography scan confirmed the L5 nerve root decompression.
CONCLUSIONS
The intraspinal misplacement of a venous stent is a rare complication that may cause nerve root injury. It requires a prompt treatment. Surgically removing the stent by a posterior approach seems to be a simple and safe therapeutic option.

Identifiants

pubmed: 32058121
pii: S1878-8750(20)30293-X
doi: 10.1016/j.wneu.2020.02.028
pii:
doi:

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

372-375

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Mélissa Di Santo (M)

Department of Neurosurgery, CHU University Hospital Center, Université Catholique de Louvain (UCL), Yvoir, Namur, Belgium. Electronic address: melissa.disanto1@gmail.com.

Asmae Belhaj (A)

Department of Vascular Surgery, CHU University Hospital Center, Université Catholique de Louvain (UCL), Yvoir, Namur, Belgium.

Benoit Rondelet (B)

Department of Vascular Surgery, CHU University Hospital Center, Université Catholique de Louvain (UCL), Yvoir, Namur, Belgium.

Thierry Gustin (T)

Department of Neurosurgery, CHU University Hospital Center, Université Catholique de Louvain (UCL), Yvoir, Namur, Belgium.

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