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Life-threatening arterioureteral fistula treatment by endovascular complete anatomic iliac artery bifurcation reconstruction.


ABSTRACT: We present an endovascular approach for anatomic reconstruction of the iliac bifurcation in life-threatening arterioureteral fistula without sacrificing the pelvic arterial vascular supply. Five consecutive patients suffering from acute onset of significant gross hematuria caused by iliac-ureteral fistula resulting from previous oncologic surgery and radiation therapy were treated by transfemoral stent graft implantation in a double-barrel technique. Iliac-ureteral pseudoaneurysm coverage succeeded in an iliac neobifurcation with preservation of pelvic perfusion. Follow-up ranging from 9 to 37 months confirmed cessation of hematuria. One patient experienced stent graft thrombosis of the external iliac artery as a result of large cervical cancer invasion treated by crossover bypass. In all other patients, stent grafts were patent.

SUBMITTER: Massmann A 

PROVIDER: S-EPMC7160530 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Life-threatening arterioureteral fistula treatment by endovascular complete anatomic iliac artery bifurcation reconstruction.

Massmann Alexander A   Fries Peter P   Shayesteh-Kheslat Roushanak R   Buecker Arno A   Stöckle Michael M   Niklas Christina C  

Journal of vascular surgery cases and innovative techniques 20200414 2


We present an endovascular approach for anatomic reconstruction of the iliac bifurcation in life-threatening arterioureteral fistula without sacrificing the pelvic arterial vascular supply. Five consecutive patients suffering from acute onset of significant gross hematuria caused by iliac-ureteral fistula resulting from previous oncologic surgery and radiation therapy were treated by transfemoral stent graft implantation in a double-barrel technique. Iliac-ureteral pseudoaneurysm coverage succee  ...[more]

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