A case of iliac-artery–ureteral fistula managed with a combined endoscopic approach

Abstract

The patient underwent placement of a covered, self-expandable vascular stent with angioplasty balloon, which resulted in complete exclusion of the pseudoaneurysm and fistula and resolution of the patient's hematuria. A pigtail catheter was placed in the right ureter for 5 days and replaced with a double-J ureteral stent on day 6 after exclusion of the pseudoaneurysm; the patient was discharged from hospital on the same day. Color-Doppler ultrasonography of the right iliac vessels performed 2 months later showed patency of the right iliac artery. The patient's ureteral stent has been replaced every 2 months since his discharge without recurrence of hematuria.

Endovascular Management of Ureteroarterial Fistula: Single Institution Experience and Systematic Literature Review

“…2,3,51 Anyways, it should be always considered in case of hematuria in patients with above-described risk factors 2,3,52 in order to achieve the correct diagnosis as soon as possible, whereas it is a potentially fatal condition that can achieve the 38% of cases. 2,3,17 Moreover, in untreated patients, early mortality does not allow to make a correct diagnosis. 2…”

Ureteroiliac fistula: a case report review of the literature

“…Ureteroscopy is also not recommended because it can tear the fistula, leading to massive hemorrhage [7]. Also the sensitivity of CT is too low to recommend it as a first line diagnostic tool [7].…”

Nephroureteral Stents: Principles and Techniques

“…Treatment options include stent grafting, embolization, and surgical repair. 8,[17][18][19] Delay in or neglecting to change a double-J stent can cause urinary crystalline components to deposit on both the inner and outer surfaces of the stent, which could lead to stent encrustation, malfunction, and possible retention. This could also make a stent exchange very difficult; a stent fracture can complicate removal.…”