Endovascular treatment of aortoureteric fistula.
OBJECTIVE
To report successful endovascular treatment of massive hemorrhage from an aortoureteric fistula.


METHODS
An 82-year-old man who had undergone total cystectomy and bilateral ureterostomy for bladder cancer was transferred with massive hemorrhage from the ureterostomy. Angiography demonstrated an aortoureteric fistula between the terminal aorta and the left ureter. The patient had pancytopenia from unknown causes on admission, so a stent-graft made from a Gianturco Z-stent covered with Dacron graft was implanted; complete hemostasis was obtained immediately. He died of coexistent plasma cell leukemia 42 days after the operation; however, complete hemostasis had been maintained, and infection around the stent-graft was not recognized at autopsy.


CONCLUSIONS
Stent-graft implantation can be a useful therapy for control of massive bleeding from an aortoureteric fistula.
Ota
Takeyoshi
T
Department of Cardiovascular Surgery, Kobe University Hospital, Kobe, Japan.
Tsuji
Yoshihiko
Y
Kawasaki
Ryuta
R
Taniguchi
Takanori
T
Morimoto
Yoshihisa
Y
Okita
Yutaka
Y
D000368:Aged; D015901:Angiography, Digital Subtraction; D017546:Angioscopy; D001012:Aorta, Abdominal; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D017809:Fatal Outcome; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015607:Stents; D014515:Ureteral Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014548:Urinary Fistula / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*