Endovascular repair of arteriovenous fistula after microendoscopic discectomy and lamino-foraminotomy.

The last two decades have seen increasing adoption of minimally invasive approaches to lumbar disc herniation management. As with many new advances in surgery, the risk profile of these contemporary approaches has yet to be well defined. We present the case of a 32-year-old man who presented with decreasing exercise tolerance over a 6-month period after microendoscopic lumbar discectomy and lamino-foraminotomy. Subsequent work-up revealed a large fistula between his right common iliac artery and inferior vena cava, resulting in high-output cardiac failure. This was managed well with an endovascular approach. This case highlights the importance of complication cognizance for patients who undergo minimally invasive lumbar disc surgery, as serious consequences can occur.