Translumbar Endovascular Coiling of an Abdominal Aortic Aneurysm Complicated by Lumbar Epidural Extravasation: A Novel Case

Abdominal aortic aneurysms (AAAs) require complex surgical management. Currently, endovascular aneurysm repair (EVAR), including the placement of stent grafts and endovascular coils, offers early survival benefits over open surgery but carries its own distinct set of complications. We report the case of a 68-year-old man with a 35-mm saccular AAA who initially underwent stent graft placement and later required additional endovascular treatment for a type 2 endoleak. Intraoperatively, part of the coil mass appeared to deviate from the expected contour of the aneurysm. Postoperative CT imaging revealed migration of the endovascular coils into the lumbar epidural space. To our knowledge, this is the first reported case of coil migration into the lumbar spinal canal following EVAR for an AAA. The patient developed progressive symptoms of lumbar stenosis and radiculopathy, ultimately requiring decompression, fusion, and removal of the migrated coils. This report presents a novel postoperative complication and underscores the importance of careful surgical planning, interdisciplinary collaboration among surgical subspecialists, and thorough clinical and radiographic follow-up.