{"id":"e97307df-699f-4fc1-97d2-b6b5d8599848","slug":"thoraco-lumbar-artery-aneurysms-associated-with-a-metameric-paraspinal-lesion-presenting-with-retroperitoneal-hemorrhage-endovascular-management","title":"Thoraco-lumbar artery aneurysms associated with a metameric paraspinal lesion presenting with retroperitoneal hemorrhage: Endovascular management","authors":["Alejandro Santillan","Walter Zink","Athos Patsalides","Y. Pierre Gobin"],"abstract":"Background: Retroperitoneal hemorrhage is a life-threatening condition. This is the first reported case of rupture of one of multiple thoraco-lumbar artery aneurysms associated with a metameric paraspinal vascular lesion. Case Description: A 77-year-old female patient presented to the emergency room with a new onset of left-sided low back pain shooting down the leg associated with weakness, numbness, and inability to walk. On physical examination, there was a notable left paraspinal swelling with a harsh bruit audible in the same area, left flank ecchymosis and a positive straight leg raising test. A computed tomography (CT) scan showed a large retroperitoneal hematoma. Digital subtraction angiography showed a large left paraspinal high-flow arteriovenous lesion, with large arterial aneurysms of the left T11, T12, and L1 segmental arteries. The patient was successfully treated with endovascular aneurysm embolization using coils and Onyx-34. Six months following the procedure, the patient had fully recovered, and a follow-up angiogram showed no residual or recurrent aneurysms. Conclusion: Thoraco-lumbar artery aneurysms have never previously been described in association with a metameric paraspinal vascular malformation. We report a case of retroperitoneal hemorrhage due to rupture of one of several high-flow artery aneurysms of a paraspinal arteriovenous malformation (AVM). The diagnosis was made on CTA, MRI, and angiography, and the lesion was successfully treated by transarterial embolization.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/e97307df-699f-4fc1-97d2-b6b5d8599848/featured/hero-1782421050265.png","publishDate":"2011-10-12T00:00:00.000Z","doi":"10.4103/2152-7806.85978","categories":["Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2015/05/3590/SNI-2-137.pdf"}