Uretero-arterial fistula: Six new cases and systematic review of the literature
| Autor: | Xavier Tillou, Grégoire Leon, C. Ghouti, Lionel Vaudreuil, K. Ait Said, Sofiane Seddik |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Urinary Fistula Urology Fistula medicine.medical_treatment 030232 urology & nephrology MEDLINE 03 medical and health sciences 0302 clinical medicine medicine Humans Ureteral Diseases Retrospective Studies Vascular Fistula business.industry Stent Vascular surgery Left Common Iliac Artery medicine.disease Surgery Arterial fistula Macroscopic haematuria Female Stents Neoplasm Recurrence Local business Pelvic radiotherapy |
| Zdroj: | Progrès en Urologie. 31:605-617 |
| ISSN: | 1166-7087 |
| DOI: | 10.1016/j.purol.2020.12.015 |
| Popis: | Summary Aim Secondary uretero-arterial fistulas (SUAF) are uncommon, underrated and threatening for any patient. Gross hematuria is a clinical symptom of this pathology for patients with history of pelvic radiotherapy, complex pelvic surgery or long-term ureteral stenting. The purpose of this work is to assess risk factors, diagnosis and treatment of SUAF. Methods Monocentric and retrospective series of 6 new cases illustrated by a literature review through MedLine and Pubmed using the keywords “arterio-ureteral fistula”, “arterio iliac fistula” and “ilio-ureteral fistula”. We excluded uretero-arterial fistula following vascular surgery. Results Our series included 4 men and 2 women. All patients had a history of complex pelvic surgery and long-term ureteral stenting. Three patients had history of pelvic radiotherapy. They all had inaugural macroscopic haematuria episode. Two fistula cases were diagnosed on 5 repeated CT-scans. In 2 out of 5 cases, arteriography highlighted the fistula. Fistulas were generally located at the left common iliac artery. An endovascular stent was placed in 5 out of 6 cases. One patient needed open surgery. After treatment, 3 patients remained alive, 3 patients died either by a fistula relapse or by complications late in the treatment. Conclusion SUAF are uncommon, but serious. Today, there is no specific recommendation regarding complex treatment of these fistulas. Endovascular stents seem to be a good therapeutic option. Level of proof 3. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|