尿管皮膚瘻造設術後に発生した尿管動脈瘻に対し血管内ステントグラフト治療を繰り返した1例

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タイトル別名
  • Several Treatments with Endovascular Stent Graft for Ureteroarterial Fistula after Construction of Cutaneous Ureterostomy : Report of a Case
  • ニョウカン ヒフロウゾウセツジュツゴ ニ ハッセイ シタ ニョウカン ドウミャクロウ ニ タイシ ケッカン ナイ ステントグラフト チリョウ オ クリカエシタ 1レイ

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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.

収録刊行物

  • 泌尿器科紀要

    泌尿器科紀要 59 (10), 647-650, 2013-10

    泌尿器科紀要刊行会

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