Balloon-Expandable Stent Graft for Treating Uretero-Iliac Artery Fistula.
OBJECTIVE
To evaluate the safety, efficacy and outcome of percutaneous balloon-expandable covered stent graft placement for uretero-iliac artery fistula (UAF) treatment.


METHODS
This retrospective study evaluated the single-center experience of percutaneous balloon-expandable covered stent graft placement (ADVANTA™, Atrium Hudson, NH, USA) in UAF. Data were obtained from a prospective institutional database. Patient follow-up included complications, symptoms recurrence and mortality rate.


RESULTS
Ten UAFs in eight patients (3 males; 5 females) with a mean age of 64.5 (35-77) years were identified. All patients had a history pelvic malignancy, extirpative surgery (n = 6), long-term ureteral stenting (n = 7) and pelvic radiation (n = 5). All procedures were completed successfully without complications. Thirty-day mortality rate was zero. At a median follow-up of 6 (1-60) months, one patient suffered recurrent hematuria requiring a secondary stent graft placement 26 months after the initial treatment. During follow-up, five patients died of the underlying disease (43, 66, 105, and 183 and 274 days after the last procedure).


CONCLUSIONS
Percutaneous balloon-expandable stent graft placement in UAF is a safe and effective treatment option. Implantation of stent grafts should be considered as treatment of choice in UAF.
Department of Diagnostic and Interventional Radiology, Marburg University Hospital, Philipps University, Baldingerstrasse, 35043, Marburg, Germany. guntau@med.uni-marburg.de.
Moritz
M
Guntau
Department of Urology and Pediatric Urology, Marburg University Hospital, Philipps University, Marburg, Germany.
Axel
A
Hegele
Department of Diagnostic and Interventional Radiology, Marburg University Hospital, Philipps University, Baldingerstrasse, 35043, Marburg, Germany.
Stephan
S
Rheinheimer
Department of Urology and Pediatric Urology, Marburg University Hospital, Philipps University, Marburg, Germany.
Rainer
R
Hofmann
Department of Diagnostic and Interventional Radiology, Marburg University Hospital, Philipps University, Baldingerstrasse, 35043, Marburg, Germany.
Andreas H
AH
Mahnken
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000295:instrumentation* / Q000379:methods*; D001807:Blood Vessel Prosthesis; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014515:Ureteral Diseases / Q000175:diagnosis / Q000628:therapy*; D014548:Urinary Fistula / Q000175:diagnosis / Q000628:therapy*; D016157:Vascular Fistula / Q000175:diagnosis / Q000628:therapy*
Endovascular treatment; Stent graft; Ureteral-iliac artery fistula; Uretero-arterial fistula