Endovascular management of ureteroarterial fistula.
Ureteroarterial fistulas, although rare, appear to be increasing in frequency. Because open surgical repair may be difficult and associated with significant risk for complications, endovascular intervention may provide an attractive treatment alternative. We review the diagnosis and management of a ureteroarterial fistula and iliac pseudoaneurysm that presented with massive hematuria during ureteral stent removal. The patient was treated by means of the percutaneous embolization of the right hypogastric artery and placement of an expanded polytetrafluoroethylene stent-graft. Endovascular stent-graft placement may serve as a safe and practical alternative in the treatment of these patients, whose cases are challenging.
Feuer
D S
DS
Division of Vascular Surgery, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick 08903, USA.
Ciocca
R G
RG
Nackman
G B
GB
Siegel
R L
RL
Graham
A M
AM
D015901:Angiography, Digital Subtraction; D020878:Device Removal; D004621:Embolization, Therapeutic; D006417:Hematuria / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000293:injuries; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015607:Stents; D014057:Tomography, X-Ray Computed; D014515:Ureteral Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D014548:Urinary Fistula / Q000000981:diagnostic imaging / Q000628:therapy*; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000628:therapy*