CASE REPORT   

Journal of Radiological Review 2021 March;8(1):51-4

DOI: 10.23736/S2723-9284.20.00094-7

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Successful endovascular treatment of massive hematuria due to ureteroarterial fistula secondary to ureterocutaneostomy

Antonio BORZELLI ✉, Francesco GIURAZZA, Fabio CORVINO, Giuseppe DE MAGISTRIS, Enrico CAVAGLIÀ, Francesco PANE, Milena COPPOLA, Francesco AMODIO, Mattia SILVESTRE, Raffaella NIOLA

Unit of Vascular and Interventional Radiology, AORN A. Cardarelli, Naples, Italy

Ureteroarterial fistula (UAF) is an uncommon condition due to a fistulous communication between a ureter and aorta or iliac artery. It is not only challenging to identify, but also potentially lethal, and it can be associated with pelvic irradiation, malignant disease and previous pelvic-abdominal surgery. UAF can be classified into primary and secondary ones: primary fistula is related to aorto-iliac aneurysms while secondary ones occur after pelvic surgery, pelvic radiation or ureteral stenting, and the most common risk factor is the presence of a chronic indwelling ureteral stent. Surgery represents the traditional therapeutic approach but, in the last years, endovascular approach has become a safe and effective minimally invasive alternative, especially in patients with many comorbidities and complicated anatomic presentation. In this manuscript, we reported the case of a 76-year-old man, with bilateral ureterocutaneostomy after previous radical cystectomy, who presented to our emergency department for gross pulsatile hematuria from the left ureterocutaneostomy, due to a UAF with the left external iliac artery, solved by endovascular placement of a covered stent graft.

KEY WORDS: Fistula; Hematuria; Stents