[Several treatments with endovascular stent graft for ureteroarterial fistula after construction of cutaneous ureterostomy : report of a case].

A 78-year-old man underwent a radical cystectomy and the construction of a cutaneous ureterostomy for bladder cancer. He had an 8 Fr single-J ureteral catheterindwelt for stomal stenosis caused by parastomal hernia. Thirty-one months after the operation, the patient was admitted with gross hematuria. Contrast-enhanced computed tomography showed a highly suspicious left uretero-iliac artery fistula (UIAF), which was finally diagnosed by angiography. A covered endovascular stent graft was placed in the left iliac artery, and the gross hematuria was resolved. Six months after the endovascular stenting, he had recurrent gross hematuria and underwent additional treatment with placement of a secondary stent graft. Two months later, a pseudoaneurysm developed in the left iliac artery, and emergency angiography was performed to treat an impending rupture of the aneurysm. During the angiography, a thrombus formed in the left iliac artery, and he died due to multiple organ failure caused by an infective thrombus and sepsis. Endovascular stent graft placement is a safe and effective treatment to manage the acute phase of ureteroarterial fistula. However, the long-term effectiveness of this treatment remains to be established.