Pseudoaneurysm of the Deep Circumflex Iliac Artery: A Rare Complication at an Anterior Iliac Bone Graft Donor Site

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Study Design.The formation of a pseudoaneurysm of the deep circumflex iliac artery after the harvesting of an anterior iliac bone graft for spinal fusion is reported.Objective.To describe a rare complication at an iliac bone graft donor site.Summary of Background Data.The iliac bone is a common site for harvesting bone for spinal surgery. Although many complications have been reported, vascular injuries associated with this procedure are rare. To the authors’ knowledge, deep circumflex iliac artery injury has not been reported as a complication.Methods.A 70-year-old man with cervical myelopathy underwent anterior cervical decompression and fusion with an anterior iliac bone graft. Fracture displacement of the anterior superior iliac spine at the donor site was noted 1 week after a second operation, which was performed to reduce the displaced grafted bone. Five months after the second operation, he reported pain and swelling at the donor site. Removal of a hematoma was attempted, which led to massive bleeding that was difficult to control.Results.Angiography demonstrated a pseudoaneurysm of the deep circumflex iliac artery. Selective embolization of the artery was performed, and the bleeding was arrested.Conclusions.Vascular injury after anterior iliac bone harvesting is rare but can occur. Selective arterial embolization was an effective solution.

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