Simultaneous Endovascular Treatment of a Ureteroiliac Fistula and Common Iliac Artery Occlusion

Wu, I-Hui; Chueh, Shih-Chieh; Liang, Po-Chin

doi:10.1016/j.ejvs.2008.08.004

Cited by 1 publication

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“…This can be caused by embolization of atherosclerotic elements, propagation of clot from local intimal injury, or even arterial vascular dissection. Although a rare complication, endovascular techniques can be used to reverse the arterial occlusion [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Ureteroarterial Fistula

Kim

Mahdy

Mundra

et al. 2009

Case Reports in Medicine

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Ureteral-iliac artery fistula (UIAF) is a rare life threatening cause of hematuria. The increasing frequency is attributed to increasing use of ureteral stents. A 68-year-old female presented with gross hematuria. She had prior low anterior resection for rectal cancer and a retained ureteral stent. CT abdomen and pelvis showed a large recurrent pelvic mass and a retained stent. The patient underwent cystoscopy which showed a normal bladder. Upon removal of the stent, brisk bleeding was noted coming from the ureteral orifice. Antegrade pyelogram was done which revealed a UIAF. Angiography was done and a covered stent was placed. Multiple treatment options are available. All must consider management of the arterial and ureteral side. The arterial side may be addressed by primary open repair, embolization with extra-anatomic vascular reconstruction, or endovascular stenting. The ureter can be managed with nephroureterectomy, ureteral reconstruction, placement of a nephrostomy tube, or ureteral stenting. Being minimally invasive, we believe that endovascular stenting should be the preferred therapeutic option as it also corrects the source of bleeding while preserving distal blood flow.

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Section: Discussionmentioning

confidence: 99%