Endovascular treatment of aortoureteric fistula.

PURPOSE: To report successful endovascular treatment of massive hemorrhage from an aortoureteric fistula.

CASE REPORT: An 82-year-old man who had undergone total cystectomy and bilateral ureterostomy for bladder cancer was transferred with massive hemorrhage from the ureterostomy. Angiography demonstrated an aortoureteric fistula between the terminal aorta and the left ureter. The patient had pancytopenia from unknown causes on admission, so a stent-graft made from a Gianturco Z-stent covered with Dacron graft was implanted; complete hemostasis was obtained immediately. He died of coexistent plasma cell leukemia 42 days after the operation; however, complete hemostasis had been maintained, and infection around the stent-graft was not recognized at autopsy.

CONCLUSIONS

Stent-graft implantation can be a useful therapy for control of massive bleeding from an aortoureteric fistula.