Iliac arteriovenous fistula as a complication of lumbar disc surgery. Report of two cases and review of literature.

Vascular lesions following surgery of the lumbar disc are very infrequent, and exceptionally an arteriovenous fistula can developed. An important proportion of the reported cases were previously diagnosed as deep venous thrombosis, because this kind of pathology was not suspected. Postsurgical arteriovenous fistula produces severe haemodynamic disturbances, and congestive heart failure will develop if they are left to their natural course without intervention. Arteriovenous fistula should be suspected in the post-operative period of the lumbar disc surgery if congestive heart failure appears, accompanied by swelling of one or both lower limbs. Early surgery is the treatment of choice in order to prevent the congestive heart failure, and to preserve the normal function of the lower extremities. The technical choice seems to be the closure of the orifice of the fistula through the arterial lumen, together with appropriate arterial reconstruction.