Kerns D B, Darcy M D, Baumann D S, Allen B T
Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
J Vasc Surg. 1996 Oct;24(4):680-6. doi: 10.1016/s0741-5214(96)70084-8.
Iliac artery-ureteral fistula is a rare entity that is being reported with increasing frequency. Patients with iliac artery-ureteral fistulas can be divided into two distinct groups on the basis of the factors that predispose them to having these fistulas. In group I the fistula is associated with degenerative iliac artery disease or previous arterial reconstructive surgery. Patients in group II have undergone some combination of the following procedures: pelvic extirpative surgery for malignancy, urinary diversion, radiation therapy, and ureteral stenting. The diagnosis of an iliac artery-ureteral fistula can be elusive even with the use of multiple imaging methods. Direct operative repair is technically demanding and is associated with high mortality rates. In recent years, treatment has shifted toward percutaneous embolization of the iliac artery and extraanatomic lower extremity vascular reconstruction for group II patients. In this report, the 24 group II patients with iliac artery-ureteral fistulas who previously have been described are reviewed, and a new endovascular treatment for this entity that uses a stented vein graft is detailed.
髂动脉-输尿管瘘是一种罕见的疾病，其报告频率正在增加。根据导致患者发生这些瘘管的因素，髂动脉-输尿管瘘患者可分为两个不同的组。在第一组中，瘘管与髂动脉退行性疾病或先前的动脉重建手术有关。第二组患者接受了以下一些手术的组合：盆腔恶性肿瘤切除手术、尿流改道、放射治疗和输尿管支架置入术。即使使用多种成像方法，髂动脉-输尿管瘘的诊断也可能难以捉摸。直接手术修复技术要求高，且死亡率高。近年来，对于第二组患者，治疗已转向髂动脉的经皮栓塞和解剖外下肢血管重建。在本报告中，回顾了先前描述的24例第二组髂动脉-输尿管瘘患者，并详细介绍了一种使用带支架静脉移植物治疗该疾病的新血管内治疗方法。
