Endovascular Management of Ureteroarterial Fistula: Single Institution Experience and Systematic Literature Review.

Autor:	Subiela JD; 1 Department of Urology, Fundació Puigvert, Universidad Aurtónoma de Barcelona, Barcelona, Spain., Balla A; 2 General and Digestive Surgery Unit, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain.; 3 Department of General Surgery and Surgical Specialties 'Paride Stefanini,' Sapienza, University of Rome, Rome, Italy., Bollo J; 2 General and Digestive Surgery Unit, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain., Dilme JF; 4 Departament of Vascular Surgery, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain., Soto Carricas B; 4 Departament of Vascular Surgery, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain., Targarona EM; 2 General and Digestive Surgery Unit, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain., Rodriguez-Faba O; 1 Department of Urology, Fundació Puigvert, Universidad Aurtónoma de Barcelona, Barcelona, Spain., Breda A; 1 Department of Urology, Fundació Puigvert, Universidad Aurtónoma de Barcelona, Barcelona, Spain., Palou J; 1 Department of Urology, Fundació Puigvert, Universidad Aurtónoma de Barcelona, Barcelona, Spain.
Jazyk:	angličtina
Zdroj:	Vascular and endovascular surgery [Vasc Endovascular Surg] 2018 May; Vol. 52 (4), pp. 275-286. Date of Electronic Publication: 2018 Feb 26.
DOI:	10.1177/1538574418761721
Abstrakt:	Background: Ureteroarterial fistula (UAF) represents an uncommon complication after urological surgery; however, this is a well-documented condition in patients with predisposing risk factors. The aim of the present study is to report and analyze the endovascular management of a series of patients with UAF, treated in authors' hospital, and to report and analyze the same data concerning patients retrieved from a systematic literature review. Methods: Authors conducted a retrospective analysis of prospectively collected data and a systematic literature review. The research was carried out through PubMed database searching the following keywords: "uretero arterial fistula" and "uretero iliac fistula." It includes only articles reporting the endovascular management. Results: Forty-six articles were included in the present study for a total of 94 patients. Risk factors were as follows: chronic indwelling ureteral stents, pelvic surgery, radiotherapy, iliac artery pseudo-aneurysm, and chemotherapy. All patients had gross hematuria at presentation. Stent graft placement was performed in 89 patients, embolization in 5 patients, and iliac internal artery embolization combined with stent graft placement was performed in 24 patients. Four postprocedural complications were observed (4.2%). During a median follow-up of 8 months, 10 complications related to UAF were observed (10.6%): rebleeding (7 cases) and stent thrombosis (3 cases). Two patients died for causes related to UAF (2.1%): rebleeding (1) and retroperitoneal abscess (1). Conclusion: Based on the present data, endovascular treatment is feasible and safe with low postprocedural complications and mortality rate. Considering the increase in surgery and radiotherapy performed, UAF should be always debated in patients with massive hematuria.
Databáze:	MEDLINE
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