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.