Abstract：
OBJECTIVE: Secondary uretero-arterial fistulas (SUAF) are uncommon, underrated and threatening for any patient. Gross hematuria is a clinical symptom of this pathology for patients with history of pelvic radiotherapy, complex pelvic surgery or long-term ureteral stenting. The purpose of this work is to assess risk factors, diagnosis and treatment of SUAF.
METHODS: Monocentric and retrospective series of 6 new cases illustrated by a literature review through MedLine and Pubmed using the keywords \"arterio-ureteral fistula\", \"arterio iliac fistula\" and \"ilio-ureteral fistula\". We excluded uretero-arterial fistula following vascular surgery.
RESULTS: Our series included 4 men and 2 women. All patients had a history of complex pelvic surgery and long-term ureteral stenting. Three patients had history of pelvic radiotherapy. They all had inaugural macroscopic haematuria episode. Two fistula cases were diagnosed on 5 repeated CT-scans. In 2 out of 5 cases, arteriography highlighted the fistula. Fistulas were generally located at the left common iliac artery. An endovascular stent was placed in 5 out of 6 cases. One patient needed open surgery. After treatment, 3 patients remained alive, 3 patients died either by a fistula relapse or by complications late in the treatment.
CONCLUSIONS: SUAF are uncommon, but serious. Today, there is no specific recommendation regarding complex treatment of these fistulas. Endovascular stents seem to be a good therapeutic option.
UNASSIGNED: 3.
METHODS: Monocentric and retrospective series of 6 new cases illustrated by a literature review through MedLine and Pubmed using the keywords \"arterio-ureteral fistula\", \"arterio iliac fistula\" and \"ilio-ureteral fistula\". We excluded uretero-arterial fistula following vascular surgery.
RESULTS: Our series included 4 men and 2 women. All patients had a history of complex pelvic surgery and long-term ureteral stenting. Three patients had history of pelvic radiotherapy. They all had inaugural macroscopic haematuria episode. Two fistula cases were diagnosed on 5 repeated CT-scans. In 2 out of 5 cases, arteriography highlighted the fistula. Fistulas were generally located at the left common iliac artery. An endovascular stent was placed in 5 out of 6 cases. One patient needed open surgery. After treatment, 3 patients remained alive, 3 patients died either by a fistula relapse or by complications late in the treatment.
CONCLUSIONS: SUAF are uncommon, but serious. Today, there is no specific recommendation regarding complex treatment of these fistulas. Endovascular stents seem to be a good therapeutic option.
UNASSIGNED: 3.
摘要：
目的：继发性输尿管动脉瘘（SUAF）并不常见，低估和威胁任何病人。对于有盆腔放疗史的患者，肉眼血尿是这种病理的临床症状，复杂的盆腔手术或长期输尿管支架置入术。这项工作的目的是评估风险因素，SUAF的诊断和治疗。
方法：单中心和回顾性系列的6例新病例，通过MedLine和Pubmed使用关键字“动脉-输尿管瘘”进行文献综述，“髂动脉瘘”和“髂输尿管瘘”。我们排除了血管手术后的输尿管动脉瘘。
结果：我们的系列包括4名男性和2名女性。所有患者均有复杂盆腔手术和长期输尿管支架置入术的病史。3例有盆腔放疗史。他们都有首次宏观血尿发作。在5次重复CT扫描中诊断出2例瘘病例。在5个案例中，有2个动脉造影突出显示了瘘管。瘘通常位于左髂总动脉。6例中有5例放置了血管内支架。一名患者需要开放手术。治疗后,3名患者仍然活着，3例患者死于瘘管复发或治疗后期并发症。
结论：SUAF并不常见，但很严肃.今天,对于这些瘘管的复杂治疗没有具体建议.血管内支架似乎是一种很好的治疗选择。
■3.
方法：单中心和回顾性系列的6例新病例，通过MedLine和Pubmed使用关键字“动脉-输尿管瘘”进行文献综述，“髂动脉瘘”和“髂输尿管瘘”。我们排除了血管手术后的输尿管动脉瘘。
结果：我们的系列包括4名男性和2名女性。所有患者均有复杂盆腔手术和长期输尿管支架置入术的病史。3例有盆腔放疗史。他们都有首次宏观血尿发作。在5次重复CT扫描中诊断出2例瘘病例。在5个案例中，有2个动脉造影突出显示了瘘管。瘘通常位于左髂总动脉。6例中有5例放置了血管内支架。一名患者需要开放手术。治疗后,3名患者仍然活着，3例患者死于瘘管复发或治疗后期并发症。
结论：SUAF并不常见，但很严肃.今天,对于这些瘘管的复杂治疗没有具体建议.血管内支架似乎是一种很好的治疗选择。
■3.
