Successful endovascular treatment of iliac arteriovesical fistula with secondary stent-graft infection.

A 58-year-old woman initially presented with massive gross hematuria and iliac arteriovesical fistula (IAVF). Endovascular stent-graft repair achieved complete exclusion of the IAVF and controlled the bleeding, but sepsis subsequently developed because of endograft infection. Endovascular embolization of the infected stent graft was performed after extraanatomic bypass surgery. The patient recovered and showed no signs of graft infection or recurrent fistulization at 14 months after treatment. Endovascular embolization of infected stent grafts combined with extraanatomic bypass may be an acceptable treatment option for graft-related sepsis in cases that are resistant to conservative treatment and pose high surgical risk for graft excision.