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

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.