Endoleak and Pseudoaneurysm Formation in the Setting of Stent Graft Infection Following Endovascular Uretero-Arterial Fistula Repair: The Dreaded Complication
| Autor: | Garret Heiberger, Douglas Yim, Abby L Perrenoud, Jackson Shriver |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Urology medicine.medical_treatment Fistula endoleak Infectious Disease 030204 cardiovascular system & hematology 03 medical and health sciences Pseudoaneurysm 0302 clinical medicine ureteroarterial fistula medicine cardiovascular diseases stent graft infection medicine.diagnostic_test Persistent hematuria business.industry General Engineering pseudoaneurysm Stent equipment and supplies medicine.disease Surgery surgical procedures operative Bypass surgery Angiography Arterial fistula Radiology Complication business 030217 neurology & neurosurgery |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| Popis: | The complication of uretero-arterial fistula after prolong ureteral stenting is well recognized. The treatment is primarily endovascular stenting across the fistulous communication accepting the potential risk of stent graft infection. Herein we present a case of a 71-year-old female who developed an uretero-arterial fistula after prolong ureteral stenting and exchanges following ileal conduit obstruction. Initial treatment with left common iliac stenting controlled the hematuria, but only temporarily. Repeat angiography revealed a type 1b endoleak requiring stent extension. Unfortunately, persistent hematuria necessitating further angiography showed the development of a saccular pseudoaneurysm around the stent graft requiring proximal stent extension. A nuclear medicine indium 111-tagged white blood cell scan with single-photon emission CT (SPECT)/CT confirmed stent graft infection. Conservative therapy with antibiotics failed, causing graft failure that ultimately required bypass surgery. |
| Databáze: | OpenAIRE |
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