Moritz Guntau1, Axel Hegele2, Stephan Rheinheimer3, Rainer Hofmann2, Andreas H Mahnken3. 1. Department of Diagnostic and Interventional Radiology, Marburg University Hospital, Philipps University, Baldingerstrasse, 35043, Marburg, Germany. guntau@med.uni-marburg.de. 2. Department of Urology and Pediatric Urology, Marburg University Hospital, Philipps University, Marburg, Germany. 3. Department of Diagnostic and Interventional Radiology, Marburg University Hospital, Philipps University, Baldingerstrasse, 35043, Marburg, Germany.
Abstract
PURPOSE: To evaluate the safety, efficacy and outcome of percutaneous balloon-expandable covered stent graft placement for uretero-iliac artery fistula (UAF) treatment. METHODS: This retrospective study evaluated the single-center experience of percutaneous balloon-expandable covered stent graft placement (ADVANTA™, Atrium Hudson, NH, USA) in UAF. Data were obtained from a prospective institutional database. Patient follow-up included complications, symptoms recurrence and mortality rate. RESULTS: Ten UAFs in eight patients (3 males; 5 females) with a mean age of 64.5 (35-77) years were identified. All patients had a history pelvic malignancy, extirpative surgery (n = 6), long-term ureteral stenting (n = 7) and pelvic radiation (n = 5). All procedures were completed successfully without complications. Thirty-day mortality rate was zero. At a median follow-up of 6 (1-60) months, one patient suffered recurrent hematuria requiring a secondary stent graft placement 26 months after the initial treatment. During follow-up, five patients died of the underlying disease (43, 66, 105, and 183 and 274 days after the last procedure). CONCLUSION: Percutaneous balloon-expandable stent graft placement in UAF is a safe and effective treatment option. Implantation of stent grafts should be considered as treatment of choice in UAF.
PURPOSE: To evaluate the safety, efficacy and outcome of percutaneous balloon-expandable covered stent graft placement for uretero-iliac artery fistula (UAF) treatment. METHODS: This retrospective study evaluated the single-center experience of percutaneous balloon-expandable covered stent graft placement (ADVANTA™, Atrium Hudson, NH, USA) in UAF. Data were obtained from a prospective institutional database. Patient follow-up included complications, symptoms recurrence and mortality rate. RESULTS: Ten UAFs in eight patients (3 males; 5 females) with a mean age of 64.5 (35-77) years were identified. All patients had a history pelvic malignancy, extirpative surgery (n = 6), long-term ureteral stenting (n = 7) and pelvic radiation (n = 5). All procedures were completed successfully without complications. Thirty-day mortality rate was zero. At a median follow-up of 6 (1-60) months, one patient suffered recurrent hematuria requiring a secondary stent graft placement 26 months after the initial treatment. During follow-up, five patients died of the underlying disease (43, 66, 105, and 183 and 274 days after the last procedure). CONCLUSION: Percutaneous balloon-expandable stent graft placement in UAF is a safe and effective treatment option. Implantation of stent grafts should be considered as treatment of choice in UAF.