Diagnosis and management of ureteroiliac artery fistula: Value of provocative arteriography followed by common iliac artery embolization and extraanatomic arterial bypass grafting

David R. Vandersteen, Richard R. Saxon, Eugene Fuchs, Frederick Keller, Lloyd M. Taylor, John Barry

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79 Citations (Scopus)

Abstract

Purpose: We describe an effective multidisciplinary approach to the diagnosis and management of ureteroarterial fistulas that reduces morbidity and mortality. Materials and Methods: Five ureteroarterial fistulas in 4 patients were studied with standard and provocative arteriography (arteriography combined with ureteral manipulation). After establishing the diagnosis, each lesion was treated with percutaneous embolic occlusion of the common iliac artery followed by extraanatomic arterial bypass grafting. All patients had chronic ureteral stenting, prior pelvic irradiation, prior pelvic surgery and intrapelvic malignancy, and all fistulas presented with urinary tract hemorrhage. Results: Standard arteriography was nondiagnostic but provocative arteriography demonstrated the fistula in each case. Successful embolization of the common iliac artery followed by extraanatomic arterial bypass grafting precluded the need for laparotomy and preserved ipsilateral renal function. Conclusions: Provocative arteriography followed by arteriographic common iliac artery embolization and extraanatomic bypass grafting was successful for the diagnosis and treatment of ureteroarterial fistulas. There was no mortality, limb loss or renal loss.

Original languageEnglish (US)
Pages (from-to)754-758
Number of pages5
JournalJournal of Urology
Volume158
Issue number3
DOIs
StatePublished - Sep 1997

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Iliac Artery
Fistula
Angiography
Arteries
Kidney
Mortality
Urinary Tract
Laparotomy
Extremities
Hemorrhage
Morbidity
Neoplasms

Keywords

  • Fistula
  • Hemorrhage
  • Radiation
  • Stents
  • Ureter

ASJC Scopus subject areas

  • Urology

Cite this

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title = "Diagnosis and management of ureteroiliac artery fistula: Value of provocative arteriography followed by common iliac artery embolization and extraanatomic arterial bypass grafting",
abstract = "Purpose: We describe an effective multidisciplinary approach to the diagnosis and management of ureteroarterial fistulas that reduces morbidity and mortality. Materials and Methods: Five ureteroarterial fistulas in 4 patients were studied with standard and provocative arteriography (arteriography combined with ureteral manipulation). After establishing the diagnosis, each lesion was treated with percutaneous embolic occlusion of the common iliac artery followed by extraanatomic arterial bypass grafting. All patients had chronic ureteral stenting, prior pelvic irradiation, prior pelvic surgery and intrapelvic malignancy, and all fistulas presented with urinary tract hemorrhage. Results: Standard arteriography was nondiagnostic but provocative arteriography demonstrated the fistula in each case. Successful embolization of the common iliac artery followed by extraanatomic arterial bypass grafting precluded the need for laparotomy and preserved ipsilateral renal function. Conclusions: Provocative arteriography followed by arteriographic common iliac artery embolization and extraanatomic bypass grafting was successful for the diagnosis and treatment of ureteroarterial fistulas. There was no mortality, limb loss or renal loss.",
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author = "Vandersteen, {David R.} and Saxon, {Richard R.} and Eugene Fuchs and Frederick Keller and Taylor, {Lloyd M.} and John Barry",
year = "1997",
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T2 - Value of provocative arteriography followed by common iliac artery embolization and extraanatomic arterial bypass grafting

AU - Vandersteen, David R.

AU - Saxon, Richard R.

AU - Fuchs, Eugene

AU - Keller, Frederick

AU - Taylor, Lloyd M.

AU - Barry, John

PY - 1997/9

Y1 - 1997/9

N2 - Purpose: We describe an effective multidisciplinary approach to the diagnosis and management of ureteroarterial fistulas that reduces morbidity and mortality. Materials and Methods: Five ureteroarterial fistulas in 4 patients were studied with standard and provocative arteriography (arteriography combined with ureteral manipulation). After establishing the diagnosis, each lesion was treated with percutaneous embolic occlusion of the common iliac artery followed by extraanatomic arterial bypass grafting. All patients had chronic ureteral stenting, prior pelvic irradiation, prior pelvic surgery and intrapelvic malignancy, and all fistulas presented with urinary tract hemorrhage. Results: Standard arteriography was nondiagnostic but provocative arteriography demonstrated the fistula in each case. Successful embolization of the common iliac artery followed by extraanatomic arterial bypass grafting precluded the need for laparotomy and preserved ipsilateral renal function. Conclusions: Provocative arteriography followed by arteriographic common iliac artery embolization and extraanatomic bypass grafting was successful for the diagnosis and treatment of ureteroarterial fistulas. There was no mortality, limb loss or renal loss.

AB - Purpose: We describe an effective multidisciplinary approach to the diagnosis and management of ureteroarterial fistulas that reduces morbidity and mortality. Materials and Methods: Five ureteroarterial fistulas in 4 patients were studied with standard and provocative arteriography (arteriography combined with ureteral manipulation). After establishing the diagnosis, each lesion was treated with percutaneous embolic occlusion of the common iliac artery followed by extraanatomic arterial bypass grafting. All patients had chronic ureteral stenting, prior pelvic irradiation, prior pelvic surgery and intrapelvic malignancy, and all fistulas presented with urinary tract hemorrhage. Results: Standard arteriography was nondiagnostic but provocative arteriography demonstrated the fistula in each case. Successful embolization of the common iliac artery followed by extraanatomic arterial bypass grafting precluded the need for laparotomy and preserved ipsilateral renal function. Conclusions: Provocative arteriography followed by arteriographic common iliac artery embolization and extraanatomic bypass grafting was successful for the diagnosis and treatment of ureteroarterial fistulas. There was no mortality, limb loss or renal loss.

KW - Fistula

KW - Hemorrhage

KW - Radiation

KW - Stents

KW - Ureter

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