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Abou Chakra M, Azoulai D, Peyromaure M, Barry Delongchamps N, Bailly H, Lucas A, Dautry R, Duquesne I. A Challenging Case of Ureteroiliac Artery Fistula Managed With an Endovascular Approach. Vasc Endovascular Surg 2022; 56:15385744221105817. [PMID: 35613948 DOI: 10.1177/15385744221105817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ureteroarterial fistula (UAF) is a rare but life-threatening condition because of massive hemorrhage. Risk factors include degenerative vascular diseases, previous vascular surgery, pelvic radiation, chemotherapy, pelvic surgery, and prolonged ureteral stenting. The most common presentation of UAF is massive hematuria with hemorrhagic shock. The diagnosis is always difficult even with angiography. Endovascular repair with stenting and/or coiling is effective and safe. The surgical treatment should be used in recurrent UAF cases. We reported a rare case describing rapid management of a UAF in a patient who presented with hematuria even when we had no diagnosis on the initial CT scan. The patient was in shock. Deployment of a stent graft within the common iliac artery bypassing the UAF was performed. The patient improved rapidly.
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Affiliation(s)
- Mohamad Abou Chakra
- Faculty of Medicine, Urology Department, 63572Lebanese University, Beirut, Lebanon
| | - David Azoulai
- Department of Urology, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, 26935Cochin Hospital, Paris, France
| | - Michael Peyromaure
- Department of Urology, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, 26935Cochin Hospital, Paris, France
| | - Nicolas Barry Delongchamps
- Department of Urology, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, 26935Cochin Hospital, Paris, France
| | - Hugo Bailly
- Department of Urology, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, 26935Cochin Hospital, Paris, France
| | - Alexandre Lucas
- Department of Diagnostic and Interventional Radiology, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, 26935Cochin Hospital, Paris, France
| | - Raphaël Dautry
- Department of Diagnostic and Interventional Radiology, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, 26935Cochin Hospital, Paris, France
| | - Igor Duquesne
- Department of Urology, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, 26935Cochin Hospital, Paris, France
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Callegari M, Thomas J, Shekar A, Fernstrum A, Chen M, Bose S, Ponsky L, Abdel-Azim A, Kashyap V, Tavri S. Arterioureteral Fistula in the Setting of an Indwelling Ureteral Stent, Ileal Conduit and History of Pelvic Radiation. Urology 2020; 140:14-17. [DOI: 10.1016/j.urology.2020.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/24/2020] [Accepted: 03/09/2020] [Indexed: 11/26/2022]
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Turo R, Hadome E, Somov P, Hamid B, Gulur DM, Pettersson BA, Awsare NS. Uretero-Arterial Fistula - Not So Rare? Curr Urol 2018; 12:54-56. [PMID: 30374282 DOI: 10.1159/000489419] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 02/07/2018] [Indexed: 12/11/2022] Open
Abstract
The first uretero-arterial fistula (UAF) was reported in 1908 by Moschcowitz. In 2009, a systematic review identified 139 cases. Since then a further 23 cases were described with 19 cases originating from a single center. It has been recognized as a very rare condition in the past. However, more recently, the increasing incidence of UAF has led us to believe that this condition is more frequent than previously described. Aging population, improved cancer survival and extensive multimodal pelvic cancer treatments have been recognized as culprits for the increased incidence of UAFs. We have reviewed literature on UAFs, identified risk factors, patho-physiology and treatment options. Also, we present a case of fistulous communication between the internal iliac artery and ureter in a patient with a potential risk factor previously not described in the literature.
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Affiliation(s)
- Rafal Turo
- Department of Urology, Countess of Chester Hospital, Chester, UK
| | - Ewere Hadome
- Department of Urology, Countess of Chester Hospital, Chester, UK
| | - Pavlo Somov
- Department of Urology, Countess of Chester Hospital, Chester, UK
| | - Bushra Hamid
- Department of Histopathology, Countess of Chester Hospital, Chester, UK
| | - Dev Mohan Gulur
- Department of Urology, Countess of Chester Hospital, Chester, UK
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