Ureteroarterial fistula embolization by transradial approach: A case report

Devulapalli, Kavi K.; Lang, Patrick; Stewart, Jessica K.

doi:10.1016/j.radcr.2021.02.004

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…Various treatment options are available for AUF, including open procedures such as local reconstruction, ligature with or without extra-anatomic reconstruction, auto-transplantation, and endovascular treatments such as embolization and covered stents [2]. Over the past few years, the treatment of AUF has shifted from open surgical approaches to endovascular methods [8][9][10]. Endovascular treatment provides several benefits over open surgery, including significantly lower mortality rates (4% vs. 9%) and availability in patients with a hostile abdomen or unstable hemodynamics [1].…”

Section: Discussionmentioning

confidence: 99%

Infection of the Aortic Stent Graft to Treat Arterioureteral Fistula

Lee,

Mo,

Jung

2023

Vasc Specialist Int

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An 84-year-old female presented to our emergency department complaining of lower abdominal pain that began the previous day. She had a history of intracerebral hemorrhage and cerebrovascular infarct and severe cognitive disorder. Abdominal computed tomography (CT) revealed bilateral internal iliac artery (IIA) aneurysms (diameter: left 55 mm, right 49 mm) with hydronephrosis and evidence of rupture on the left side (Fig. 1). The patient and their caregiver refused open repair considering the patient's advanced age and poor general condition; therefore, the left IIA aneurysm was embolized, and a percutaneous nephros-

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Section: Discussionmentioning

confidence: 99%

Infection of the Aortic Stent Graft to Treat Arterioureteral Fistula

Lee,

Mo,

Jung

2023

Vasc Specialist Int

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Management and endovascular therapy of ureteroarterial fistulas: experience from a single center and review of the literature

et al. 2021

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Background Ureteroarterial fistula (UAF) is a rare but potentially life threatening disease. The aim of this study was to evaluate the outcome of endovascular therapy for UAF treatment. Methods This retrospective case series evaluates a single center experience of percutaneous stent graft (SG) angioplasty and/or coil embolization for UAF. Patient follow-up included technical and early clinical success, complications and revisional procedures. We also conducted a systematic review of the literature reporting on endovascular UAF management. Results We identified 17 UAF in 16 patients (12 male, 4 female, mean age 69.8 ± 11.3 years) who underwent endovascular UAF therapy at our tertiary hospital. All patients presented with hematuria. 5/17 (29.4%) presented with flank pain, in 7 (41.2%) cases patients were in hypovolemic shock. Risk factors of UAF included chronic indwelling ureteral stents in all fistulas, major pelvic surgery in 13 cases (76.5%). In 6 cases (35.3%) SG were placed from the common iliac artery (CIA) to the external iliac artery (EIA) following coil embolization of the proximal internal iliac artery (IIA). SG placement without previous coil embolization was performed in 10 fistulas (58.8%). In one case only coil embolization of the IIA was performed. Mean follow-up was 654 (range: 1–3269) days. All procedures were technically successful and no procedure related deaths occurred during follow-up. During the initial hospital stay hematuria disappeared in 14/17 cases (82.4%). Overall, four patients suffered recurrent hematuria, which in three cases resolved after a secondary intervention. One recurrent UAF related death occurred during follow-up 229 days after initial treatment. A total of 152 UAF cases were additionally analyzed from our systematic literature review: SG placement with or without embolization was performed in 140 cases (92.1%) while embolization alone was done in 12 cases (7.9%). Complications included UAF recurrence (18/152, 11.8%), SG thrombosis (7/140, 5%), and SG infections (5/140, 3.6%) with an overall complications rate of 13.8%. Five patients died due to UAF (3.3%). Conclusion Endovascular therapy offers high technical success rates and rapid bleeding control of UAF. Severe complications like SG occlusions or SG infections are rare but significant. Antibiotic treatment and single anti-platelet therapy improve SG durability as well as close and long follow-up to timely perform repeated endovascular or surgical treatment if necessary. Evidence-based medicine Level 4, case series.

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Ureteroarterial fistula embolization by transradial approach: A case report

Cited by 2 publications

References 6 publications

Infection of the Aortic Stent Graft to Treat Arterioureteral Fistula

Infection of the Aortic Stent Graft to Treat Arterioureteral Fistula

Management and endovascular therapy of ureteroarterial fistulas: experience from a single center and review of the literature

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