Angiographic arterial occlusion and extra-anatomical vascular bypass for the management of a ureteral-iliac fistula: case report and review of the literature

Abstract

Ureteroarterial fistulas related to nonvascular etiology are rare clinical entities that are difficult to diagnose and manage. Diagnosis is best made by a combination of studies, including digital subtraction angiography. Low morbidity and mortality rates have been described with either percutaneous thrombosis of the iliac artery and extra-anatomic bypass, or by placement of a stented graft in the involved artery. We report on a well-documented case of a ureteroarterial fistula managed successfully with interventional radiologic embolization of the common iliac artery and immediate femoral-femoral arterial bypass. A review of the literature supports this approach.