Uretro-arterial fistulas.
Ureteral arterial fistula (UAF) is an uncommon condition but one that has been increasing with over 100 cases reported. The presentation is gross hematuria in a patient with predisposing factors, such as prior pelvic surgery, past radiation therapy, and chronic ureteral stenting. When not correctly diagnosed, the associated mortality is significant. Diagnosis is best accomplished by careful angiography with frequent use of provocative maneuvers. The current best therapeutic option is sealing off the UAF by deploying a stent graft in the artery.
Darcy
Michael
M
Department of Radiology, Mallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO 63110, USA. darcym@wustl.edu
D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D004621:Embolization, Therapeutic / Q000009:adverse effects; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome; D014515:Ureteral Diseases / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D014548:Urinary Fistula / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D016157:Vascular Fistula / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*