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Abstract
Introduction/Background Arterio-ureteral fistulae are abnormal connections between an artery and the ureter and carry a high mortality. All patients were treated with a uretral and a endovascular fully covered stent placement. Objectives: Arterio-ureteral fistulae are abnormal connections between blood vessels and the ureter and most commonly involve the iliac arteries and the ureter. They are rare entities, and only around 200 cases have been reported in the literature. However, the majority of fistulae are secondary, occurring due to radiation or surgery for urological and gynecological cancers, vascular or pelvic surgeries. Our procedure consents include a statement regarding the use of images such as radiographs without patient identifiers for teaching and illustrative purposes. Our institutional policy does not require patient consents for case reports. Case reports are also exempt from institutional board review.
Methodology We present 18 cases of arterio-ureteral fistulae that presented with lifethreatening hematuria. 10 patients were treated successfully with ureteral covered stent placement (Allium ureteral stent 200x9 mm) and 8 patients are combined treated with uretral (Allium ureteral stent 200x9 mm) and endovascular (Endovascular Stent Graft) covered stents placement. Mean surgery time was 55 min (16–95 min). The position, continuity and sealing of the stent in the ureter and vessel were documented by radiological contrast imaging.
Results All patients were treated successfully with ureteral or with combined uretral and endovascular covered stent placement.
Conclusion In conclusion, ureteral or with combined uretral and endovascular covered stent placement of covered stents is a feasible minimal invasive therapeutic option for the treatment of acute life-threatening hemorrhage due to arterio-uretral fistulae.