Araki Takuji, Nagata Motonori, Araki Tsutomu, Takihana Yoshio, Takeda Masayuki
Department of Radiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo 409-3898, Japan.
Radiat Med. 2008 Jul;26(6):372-5. doi: 10.1007/s11604-008-0235-x. Epub 2008 Aug 3.
Ureteroarterial fistula is a rare condition with life-threatening hematuria that should be diagnosed and treated immediately. We reported two patients of ureteroarterial fistula who underwent successful endovascular treatment by stent-grafts. They had undergone pelvic surgery followed by placement of an indwelling ureteral stent for stricture of the ureter before sudden hematuria occurred. Routine contrast-enhanced computed tomography did not reveal extravasation or a pseudo-aneurysm. Angiograms with multiple oblique views demonstrated small pseudoaneurysms of the iliac artery overriding the ipsilateral ureter. The endovascular treatment of ureteroarterial fistula using stent-grafts was successful, and the hematuria disappeared immediately after stent-graft deployment. The hematuria did not recur up to the last follow-up visits of 3 and 19 months, respectively.
输尿管动脉瘘是一种罕见的疾病,伴有危及生命的血尿,应立即进行诊断和治疗。我们报告了两名输尿管动脉瘘患者,他们通过支架移植物成功接受了血管内治疗。他们曾接受盆腔手术,随后因输尿管狭窄放置了留置输尿管支架,之后突然出现血尿。常规对比增强计算机断层扫描未显示造影剂外渗或假性动脉瘤。多个斜位血管造影显示髂动脉小假性动脉瘤覆盖同侧输尿管。使用支架移植物对输尿管动脉瘘进行血管内治疗取得成功,支架移植物置入后血尿立即消失。分别在3个月和19个月的最后一次随访中,血尿均未复发。