Ureteroarterial Fistulas: Diagnosis, Management, and Clinical Evolution

Lara-Hernández, R.; Vázquez, R. Riera; Castany, Noé Benabarre; Sanchis, Paloma; Lozano-Vilardell, P.

doi:10.1016/j.avsg.2017.05.001

Cited by 6 publications

(2 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…26–28 Other studies report on recurrent complications related to this treatment, like infection of the stent-graft with the need to convert to open surgery. 6,29–31 However, all of these studies did not determine the rate of stent-graft infection and recurrent bleeding. In our study, we used endovascular treatment in 80% of our patients.…”

Section: Discussionmentioning

confidence: 99%

Endovascular and open surgical options in the treatment of uretero-arterial fistulas

et al. 2020

View full text Add to dashboard Cite

Objective To report and analyze the indications and results of endovascular and open surgical treatment for uretero-arterial fistula. Methods We retrospectively reviewed the clinical data of 25 consecutive patients with uretero-arterial fistulas admitted to our hospital from 2011 to 2020. Endpoints were technical success, freedom from open conversion, stent-graft/graft-related complications, and 30-day and one-year mortality. Results The study included 25 patients (68% female, n = 17) with 27 uretero-arterial fistulas by bilateral pathologies in two patients. The mean age was 61 ± 11 years (range 35–80). The most common predisposing factors for uretero-arterial fistula were history of pelvic operations for malignancy in 21 patients (84%), radiotherapy in 21 patients (84%), previous pelvic vascular bypass in 2 patients (8%), and iliac aneurysms in 2 patients (8%). On average, the period between the primary pelvic surgery and the diagnosis of uretero-arterial fistulas was 46 months (range 7–255). Twenty patients (80%) underwent endovascular treatment of the uretero-arterial fistulas. The primary technical success of the endovascular treatment was 95%, and the freedom from open conversion was 40% at six months and 30% at one year. Thirteen uretero-arterial fistulas (48%) underwent delayed open conversion due to recurrent bleeding in six cases (46%), stent-graft infection in three cases (23%), or pelvic abscess in four cases (31%). Primary open surgery was applied for five (20%) patients. After a mean follow-up of 34 months, early (<30 days) mortality was 8% (2/25), one-year mortality 16% (4/25), and overall mortality was 24% (6/25). Conclusions Uretero-arterial fistula is a late complication of prior pelvic surgery, radiation, and indwelling ureteral stents. Endovascular treatment remains an effective and less invasive modality in controlling the related life-threatening arterial bleeding of the uretero-arterial fistula. Open surgical treatment is still required for patients with local sepsis, previously failed endovascular treatment or infected stent-grafts.

show abstract

Section: Discussionmentioning

confidence: 99%

Endovascular and open surgical options in the treatment of uretero-arterial fistulas

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Further studies are required to determine the optimal course of antibiotics. No long-term follow-up has been published to assess the possible complications arising from the technique, such as prosthetic infection, nor have antibiotic treatment protocols been established; thus, long-term follow-up is necessary to determine late complications of endovascular management of UAFs 24 …”

Section: Discussionmentioning

confidence: 99%

Endovascular management and the risk of late failure in the treatment of ureteroarterial fistulas

Titomihelakis

Feghali

Nguyen

et al. 2019

Journal of Vascular Surgery Cases, Innovations and Techniques

View full text Add to dashboard Cite

Ureteroarterial fistula (UAF) is a rare and life-threatening source of hematuria. A high index of suspicion is warranted for early diagnosis and timely intervention. Because of high perioperative risk and comorbidities in UAF patients, the endovascular approach has become preferred for repair. Infection can complicate this mode of therapy, and treatment with antibiotics is important. Herein we present five cases of secondary UAFs treated with stent graft alone or stent graft and embolization.

show abstract