Muradi Akhmadu, Yamaguchi Masato, Idoguchi Koji, Okada Takuya, Nomura Yoshikatsu, Okita Yutaka, Sugimoto Koji
1Center for Endovascular Therapy, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan.
Vasc Endovascular Surg. 2014 Feb;48(2):159-61. doi: 10.1177/1538574413510620. Epub 2013 Nov 6.
Stent graft placement for ureteroarterial fistula is the preferred treatment. However, some pitfalls may occur during the procedure. Chronic inflammation process will induce longer adhesion area between artery and ureter, which results in unusual fistula site and rigid iliac arteries. This further leads to difficulty in advancing the endograft delivery system, even when access route is large enough. Multiple attempts to pass the iliac artery may result in "incidental" mechanical provocative angiography with subsequent massive bleeding. These suggested us not only to be careful and prepared but also to consider that angiography after inserting the delivery system could give additional information on the exact fistula site.
支架移植物置入术治疗输尿管动脉瘘是首选治疗方法。然而，该手术过程中可能会出现一些问题。慢性炎症过程会导致动脉与输尿管之间的粘连面积增大，从而导致瘘口位置异常以及髂动脉僵硬。这进一步导致即使通路足够大，也难以推进腔内移植物输送系统。多次尝试通过髂动脉可能会导致“意外”的机械性刺激性血管造影，随后出现大量出血。这些提示我们不仅要小心谨慎并做好准备，还要考虑在插入输送系统后进行血管造影，这可能会提供有关瘘口确切位置的更多信息。
