Ureteral stent-related aortoureteric fistula: case report and literature review

Dangle, Pankaj P.; Bahnson, Robert R.; Patel, Ashay

doi:10.5489/cuaj.1187

Cited by 8 publications

(8 citation statements)

References 8 publications

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“…However, Krambeck et al [ 10 ] and Dervanian et al [ 11 ] concluded that computed tomography and arteriography have low diagnostic accuracy for UAF. Quillin et al [ 12 ] and Dangle et al [ 13 ] reported that the diagnostic accuracy of arteriography for UAF was only 23% to 41%. Therefore, when patients with risk factors for UAF present with unexplained hematuria, UAF cannot be completely excluded, even if multiple arteriography is negative[ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Uretero-lumbar artery fistula: A case report

Chen¹,

Wang²,

Zheng³

et al. 2021

WJCC

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BACKGROUND Uretero-arterial fistula (UAF) is a disease that usually involves the aorta, common iliac artery, external iliac artery, hypogastric artery, and lumbar artery. Among them, uretero-lumbar artery fistula (ULAF) is the most unusual type. So, both in China and around the world, the diagnosis and treatment of ULAF is a big challenge. CASE SUMMARY A 55-year-old female patient with a history of pelvic radiotherapy developed unexplained massive hemorrhage during replacement of the right Resonance metallic ureteral double-J tubes due to a long-standing indwelling ureteral stent for ureteral stricture. Later, we found contrast extravasation from the patient's right L4 artery into the ureter under digital subtraction angiography (DSA) and administered polyvinyl alcohol particle embolic agent and coil embolization; hematuria was controlled. Follow-up investigations at 18 mo showed no sign of recurrence. CONCLUSION DSA is very important in the diagnosis and treatment of UAF, and DSA should be preferred when UAF is suspected. In addition, the use of softer ureteral stents in patients with primary disease and risk factors for UAF should be considered to avoid increasing the risk of the development of the disease; endovascular treatment should be preferred in patients who have developed UAF.

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Section: Discussionmentioning

confidence: 99%

Uretero-lumbar artery fistula: A case report

Chen¹,

Wang²,

Zheng³

et al. 2021

WJCC

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“…18–20 Chronic indwelling ureteral stents in patients with a history of pelvic malignancy can also precipitate the formation of UAFs. 18,21,22…”

Section: Discussionmentioning

confidence: 99%

Endovascular and open surgical options in the treatment of uretero-arterial fistulas

et al. 2020

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Objective To report and analyze the indications and results of endovascular and open surgical treatment for uretero-arterial fistula. Methods We retrospectively reviewed the clinical data of 25 consecutive patients with uretero-arterial fistulas admitted to our hospital from 2011 to 2020. Endpoints were technical success, freedom from open conversion, stent-graft/graft-related complications, and 30-day and one-year mortality. Results The study included 25 patients (68% female, n = 17) with 27 uretero-arterial fistulas by bilateral pathologies in two patients. The mean age was 61 ± 11 years (range 35–80). The most common predisposing factors for uretero-arterial fistula were history of pelvic operations for malignancy in 21 patients (84%), radiotherapy in 21 patients (84%), previous pelvic vascular bypass in 2 patients (8%), and iliac aneurysms in 2 patients (8%). On average, the period between the primary pelvic surgery and the diagnosis of uretero-arterial fistulas was 46 months (range 7–255). Twenty patients (80%) underwent endovascular treatment of the uretero-arterial fistulas. The primary technical success of the endovascular treatment was 95%, and the freedom from open conversion was 40% at six months and 30% at one year. Thirteen uretero-arterial fistulas (48%) underwent delayed open conversion due to recurrent bleeding in six cases (46%), stent-graft infection in three cases (23%), or pelvic abscess in four cases (31%). Primary open surgery was applied for five (20%) patients. After a mean follow-up of 34 months, early (<30 days) mortality was 8% (2/25), one-year mortality 16% (4/25), and overall mortality was 24% (6/25). Conclusions Uretero-arterial fistula is a late complication of prior pelvic surgery, radiation, and indwelling ureteral stents. Endovascular treatment remains an effective and less invasive modality in controlling the related life-threatening arterial bleeding of the uretero-arterial fistula. Open surgical treatment is still required for patients with local sepsis, previously failed endovascular treatment or infected stent-grafts.

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“…Possible causes include aorto-iliac bypasses, pelvic oncologic surgery, radiotherapy, and prolonged ureteral instrumentation. 3,4,9,12,14,15 Table 1 Illustrates a selected review of prior case reports from the literature on UAF. Our case is unique in that the fistula was likely created by laser lithotripsy rather than erosion and fistulizing to the AFB limb.…”

Section: Discussionmentioning

confidence: 99%

“…1 These fistulae are either primary or secondary with primary fistulae resulting from arterial aneurysmal disease and secondary fistulae arising due to previous ureteral instrumentation, pelvic surgery, and pelvic radiation. 2 -5…”

Section: Introductionmentioning

confidence: 99%

Uretero-Arterial Fistula: A Case Report and Review of the Literature

Abbas

Salhanick

Kirkwood

2020

Vasc Endovascular Surg

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Uretero-arterial fistula (UAF) is a rare complication of either aneurysmal disease primarily or pelvic inflammation secondary to urologic, oncologic, or vascular interventions. Diagnosis can be difficult to confirm and treatment may need to proceed on high index of suspicion alone. We present the case of a 56-year-old woman suffering from intermittent hematuria after laser lithotripsy leading to UAF between her left ureter and left Dacron aortobifemoral bypass limb. The fistula was successfully treated with endovascular intervention.

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Ureteral stent-related aortoureteric fistula: case report and literature review

Cited by 8 publications

References 8 publications

Uretero-lumbar artery fistula: A case report

Uretero-lumbar artery fistula: A case report

Endovascular and open surgical options in the treatment of uretero-arterial fistulas

Uretero-Arterial Fistula: A Case Report and Review of the Literature

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