title: Lessons learned from endovascular management of ureteroarterial fistula.
abstract: Stent graft placement for ureteroarterial fistula is the preferred treatment. However, some pitfalls may occur during the procedure. Chronic inflammation process will induce longer adhesion area between artery and ureter, which results in unusual fistula site and rigid iliac arteries. This further leads to difficulty in advancing the endograft delivery system, even when access route is large enough. Multiple attempts to pass the iliac artery may result in "incidental" mechanical provocative angiography with subsequent massive bleeding. These suggested us not only to be careful and prepared but also to consider that angiography after inserting the delivery system could give additional information on the exact fistula site.
authors.affiliation: 1Center for Endovascular Therapy, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan.
authors.forename: Akhmadu
authors.initials: A
authors.lastname: Muradi
authors.forename: Masato
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Koji
authors.initials: K
authors.lastname: Idoguchi
authors.forename: Takuya
authors.initials: T
authors.lastname: Okada
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Nomura
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Okita
authors.forename: Koji
authors.initials: K
authors.lastname: Sugimoto
mesh_terms: D000368:Aged; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014515:Ureteral Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D014548:Urinary Fistula / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016157:Vascular Fistula / Q000150:complications / Q000175:diagnosis / Q000601:surgery*
keywords: provocative angiography; rigid arteries; ureteroarterial fistula