Endovascular management of ureteral-iliac artery fistulae with Wallgraft endoprostheses

Gynecologic Oncology
David C MadoffMarshall E Hicks

Abstract

Ureteral-iliac artery fistulae are rare, yet potentially life-threatening, causes of hematuria. Treatment has traditionally been surgical, but advances in endovascular technology have led to a few recent reports of therapy with covered stents. We report two cases of patients diagnosed with ureteral-iliac artery fistulae who were treated with Wallgraft endoprostheses, a new, commercially available covered stent. We report two patients with gynecologic malignancies who presented with massive hematuria and hypotension and were subsequently proven to have ureteral-iliac arterial fistulae. Both patients had prior pelvic surgery, radiation, and chronic indwelling ureteral stents. Once the diagnosis was established, both patients were managed with endovascular covered stent placement. The patients' conditions stabilized, hematuria ceased, and both were discharged from the hospital without additional transfusion or surgical treatment. Endovascular therapy with covered stents is a safe, effective, and readily available method for the treatment of ureteral-iliac artery fistulae.

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Citations

Apr 22, 2004·AJR. American Journal of Roentgenology·David C MadoffMarshall E Hicks
Dec 13, 2005·Der Urologe. Ausg. A·A W Krautschick-WilkensH Stolle
Nov 8, 2007·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·P F EscobarJ W Orr
Jul 25, 2013·Journal of Vascular Surgery·Gabriel BietzEric D Endean
Oct 14, 2005·Journal of Vascular and Interventional Radiology : JVIR·Katsuhiro KobayashiDavid C Madoff
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Dec 1, 2009·Techniques in Vascular and Interventional Radiology·Michael Darcy
Apr 24, 2015·AJR. American Journal of Roentgenology·Anil Kumar PillaiSanjeeva P Kalva
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Jan 7, 2018·Journal of Endourology·Hendrik HeersAxel Hegele
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Apr 1, 2021·AJR. American Journal of Roentgenology·Felipe MatsunagaSidhartha Tavri
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Dec 14, 2018·Journal of Vascular Surgery Cases and Innovative Techniques·Jeroen J W M BrouwersJan van Schaik

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