Annals of Vascular Surgery

, Volume 18, Issue 1, pp 48–51 | Cite as

Left Iliac Artery Thrombosis during Anterior Lumbar Surgery

  • Salvador A. BrauEmail author
  • Rick B. Delamarter
  • Michael L. Schiffman
  • Lytton A. Williams
  • Robert G. Watkins
Papers Presented to the Southern California Vascular Surgical Society


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.


Compartment Syndrome Total Disc Replacement Anterior Lumbar Interbody Fusion Artificial Disc Pulse Oxymetry 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Salvador A. Brau
    • 1
    • 2
    Email author
  • Rick B. Delamarter
    • 3
  • Michael L. Schiffman
    • 4
  • Lytton A. Williams
    • 5
  • Robert G. Watkins
    • 5
  1. 1.Spine Access Surgery Associates, Los Angeles, CAUSA
  2. 2.Department of SurgeryUCLA School of Medicine, Los Angeles, CAUSA
  3. 3.The Spine Institute at Saint John’s Hospital, Department of OrthopedicsUCLA School of Medicine, Santa Monica, CAUSA
  4. 4.Southern California Orthopedic Professionals, Los Angeles, CAUSA
  5. 5.Los Angeles Spine Surgery Institute, Department of SurgeryKeck School of Medicine at University of Southern California, Los Angeles, CA USA

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