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输尿管动脉瘘:血管内支架置入成功后迟发性感染性髂总动脉假性动脉瘤形成及文献综述

Ureteroarterial fistula: Late infectious common iliac artery pseudoaneurysm formation following successful endovascular stenting and literature review.

作者信息

Hiruta Shinnosuke, Shinojima Toshiaki, Takahashi Masao, Nonaka Takao, Matsumoto Harunobu, Asakura Hirotaka

机构信息

Department of Urology Saitama Medical University Moroyama Saitama Japan.

Department of Radiology Saitama Medical University Moroyama Saitama Japan.

出版信息

IJU Case Rep. 2025 Apr 29;8(4):305-309. doi: 10.1002/iju5.70002. eCollection 2025 Jul.

Abstract

INTRODUCTION

The long-term prognosis of endovascular stenting for ureteroarterial fistulas is not always favorable. We present a case in which endovascular repair of a ureteroarterial fistula led to the development of an infectious iliac artery pseudoaneurysm that required open vascular graft replacement 1 year later.

CASE PRESENTATION

A 38-year-old woman with radiation-induced vesicovaginal fistula and bilateral ureteral stenosis underwent urinary diversion using an ileal conduit. During left ureteral stent exchange, a ureteroarterial fistula occurred on the left side and was successfully treated with vascular stent grafting. One year later, gross hematuria recurred, requiring open surgical intervention because of the formation of an infectious pseudoaneurysm near the aortic bifurcation.

CONCLUSION

Several patients treated with stent grafting for ureteroarterial fistulas require subsequent reintervention. Urologists managing patients with ureteroarterial fistulas should collaborate closely with interventional radiologists and vascular surgeons to ensure comprehensive care.

摘要

引言

输尿管动脉瘘的血管内支架置入术的长期预后并非总是良好。我们报告一例输尿管动脉瘘血管内修复术后发生感染性髂动脉假性动脉瘤的病例,1年后需要行开放性血管移植置换术。

病例介绍

一名38岁患有放射性膀胱阴道瘘和双侧输尿管狭窄的女性接受了回肠代膀胱术进行尿液改道。在左侧输尿管支架更换过程中,左侧发生输尿管动脉瘘,通过血管支架植入术成功治疗。1年后,再次出现肉眼血尿,因主动脉分叉附近形成感染性假性动脉瘤,需要进行开放性手术干预。

结论

几名接受输尿管动脉瘘支架植入治疗的患者需要后续再次干预。处理输尿管动脉瘘患者的泌尿外科医生应与介入放射科医生和血管外科医生密切合作,以确保全面护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c411/12212935/d1edd5356b20/IJU5-8-305-g001.jpg

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