[Endovascular stent graft for management of ureteroarterial fistula: a case report]

Abstract

We report a case of ureteral-iliac artery fistula and its minimally invasive management with endovascular stent grafting. A 76-year-old male was admitted with massive gross hematuria from an ilial conduit. He underwent a radical cystectomy with ileal loop urinary diversion for bladder cancer 7 months ago and had undergone placement of a 7 Fr single-J ureteral catheter for repair of a partial disruption of the left ureteroileal anastomosis. Although the fistula was not confirmed radiographically, a left ureteral-common iliac artery fistula was highly suspected. The patient was treated by percutaneous placement of an autoexpandable covered stent graft across the left common iliac and left external iliac artery. After successful endovascular management of the ureteroarterial fistula, the patient's hematuria resolved and he recovered fully. During 10 months of follow up, he has been free of hemorrhagic episodes. Because open surgical repair may be difficult and associated with significant risk for complications, endovascular intervention may provide a safety treatment alternative.