title: Management Strategy for Ureteral-Iliac Artery Fistula.
abstract: BACKGROUND
  Ureteral-iliac artery fistula (UIAF) is a rare but a potentially life-threatening condition. In this study, we reported our results of UIAF treated by open surgical and endovascular treatment.
  
  
  METHODS
  In this single-center, retrospective observational cohort study, we reviewed 6 consecutive patients who were diagnosed with a UIAF and received either open surgical or endovascular treatment based on the specific risk profile of each patient.
  
  
  RESULTS
  All patients had an indwelling ureteral stent for a ureteral stricture, with an average ureteral stenting duration of 22 months (range, 1-74 months), and 2 patients had a history of endovascular treatment with stent grafts for UIAF. Contrast-enhanced computed tomographic angiography was positive in 4 patients. Blood and urine cultures were positive in 2 and 4 patients, respectively. Four patients, including 2 with previously failed endovascular treatment, received open surgical repair. The remaining 2 patients received either endovascular treatment with stent grafts or a hybrid procedure. During the mean follow-up period of 20.3 months (range, 6-29 months), there was no symptomatic recurrence of the UIAF.
  
  
  CONCLUSIONS
  A multidisciplinary approach is highly preferable for treating potentially life-threatening UIAF. Endovascular treatment with stent grafts is currently recommended in selected patients whenever possible, but open surgical treatment is required in certain patients with enteric contamination, abscess, local sepsis, or previously failed endovascular treatment.
authors.affiliation: Department of Physical Education, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Sir-Yeon
authors.initials: SY
authors.lastname: Hong
authors.affiliation: Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Minsu
authors.initials: M
authors.lastname: Noh
authors.affiliation: Department of Radiology, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Gi-Young
authors.initials: GY
authors.lastname: Ko
authors.affiliation: Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Youngjin
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Hyunwook
authors.initials: H
authors.lastname: Kwon
authors.affiliation: Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Tae-Won
authors.initials: TW
authors.lastname: Kwon
authors.affiliation: Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea. Electronic address: ypcho@amc.seoul.kr.
authors.forename: Yong-Pil
authors.initials: YP
authors.lastname: Cho
mesh_terms: D000368:Aged; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000295:instrumentation; D018579:Patient Selection; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014515:Ureteral Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D014548:Urinary Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000601:surgery*