Introduction
Peripheral nerve injuries, including plexopathy are an important cause
of disability with the neurological sequelae affecting activities of
daily living and quality of life. Lumbosacral plexopathy represents a
distinct entity of peripheral nerve disorders due to its relative
rarity.
The lumbosacral
plexus represents
the nerve
supply to the lower back, pelvis and legs and is derived from the
ventral rami of the L1-S4 nerve roots.1 Common
etiologies for lumbosacral plexopathy including diabetes, neoplastic
invasion, radiation, trauma, infection, inflammatory, infiltrative and
vascular causes like ischemia, hemorrhage and direct compression by
aorto-iliac aneurysm.1
The lumbosacral plexus has a very rich vascular supply from the five
lumbar arteries that originate from the abdominal aorta, the deep
circumflex iliac artery that branches from the external iliac artery,
and the iliolumbar and gluteal branches of the internal iliac
artery.2 Due to its rich vascular supply, ischemia of
the plexus is rather unusual. However, ischemic lumbosacral plexopathy
has been reported with aorto-iliac procedure3. The
overall neurological risk for endovascular and open abdominal aortic
surgery ranges between 0–1%.4 Neurological
complication of nonselective or inadvertent embolization of lumbar
arteries is extremely rare but is a known
complication.5
We report a case of ischemic lumbosacral plexopathy in a woman who
underwent selective embolization of type 2 endoleak.