title: Endovascular treatment of a ureteroiliac fistula associated with ureteral double J-stenting and an aortic-bifemoral stent graft for an inflammatory abdominal aortic aneurysm.
abstract: We report an unusual case of a ureteroiliac fistula due to prolonged ureteral stenting for hydronephrosis combined with an aortic-bifemoral stent graft in an inflammatory abdominal aortic aneurysm (AAA), treated with an endovascular stent graft. In a 77-year-old man ureteral J-stents were placed for bilateral hydronephrosis due to retroperitoneal fibrosis caused by an inflammatory AAA. The aneurysm was treated with an endovascular aortic-bifemoral stent graft. Three months later, the patient suffered from severe hypovolemic shock. Emergency angiography showed a fistula between the right ureter and the right common iliac artery just distal to the right leg of the stent graft. The ureteroiliac fistula was treated with a wall graft (10F). The patient recovered well and remained asymptomatic. Ureteroiliac fistula remains a rare complication of ureteral stenting. Several risk factors have been described before. This case emphazes the increased risk of an arterial-ureteral fistula due to an indwelling ureteral stent and an inflammatory AAA, especially in combination with an additional stent graft for this inflammatory AAA.
authors.affiliation: Department of Vascular Surgery, St. Lucas Hospital, Ghent, Belgium.
authors.forename: Daan J
authors.initials: DJ
authors.lastname: Meester
authors.forename: Krijn W
authors.initials: KW
authors.lastname: van Muiswinkel
authors.forename: Filip
authors.initials: F
authors.lastname: Ameye
authors.forename: Hendrik
authors.initials: H
authors.lastname: Fransen
authors.forename: Luc
authors.initials: L
authors.lastname: Stockx
authors.forename: Luc
authors.initials: L
authors.lastname: Merckx
authors.forename: Andre
authors.initials: A
authors.lastname: Nevelsteen
mesh_terms: D000368:Aged; D017130:Angioplasty; D001011:Aorta / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D008297:Male; D011859:Radiography; D015607:Stents / Q000009:adverse effects*; D014515:Ureteral Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D014546:Urinary Catheterization / Q000009:adverse effects*; D014548:Urinary Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*