Adjunctive endovascular stent graft reinforcement of the common iliac vein for safer anterior lumbar interbody fusion

Anterior lumbar surgery is associated with risk of vascular complications that lead to termination of surgical goals. We present the case of a 52-year-old male sustaining injury to the left common iliac vein (CIV) during exploration of the retroperitoneum for revision L5-S1 anterior lumbar interbody fusion. One day after initial exploration and CIV repair, a thoracic endovascular stent graft was placed across the left CIV, allowing for completion of revision anterior lumbar interbody fusion. Adjunctive endograft placement can assist prevention of compounding iatrogenic venous injuries during anterior lumbar surgery. Patients at high risk of injury may benefit most after options are weighed.