Endoleak and Pseudoaneurysm Formation in the Setting of Stent Graft Infection Following Endovascular Uretero-Arterial Fistula Repair: The Dreaded Complication

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 a...

Full description

Saved in:
Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2020-06, Vol.12 (6)
Main Authors: Perrenoud, Abby L, Heiberger, Garret, Shriver, Jackson, Yim, Douglas
Format: Article
Language:English
Subjects:
Antibiotics
Blood
Case reports
Fistula
Hematuria
Infections
Infectious Disease
Medical imaging
Pseudoaneurysm
Radiology
Stents
Urine
Urology
Veins & arteries
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.8830