%0 Journal Article
%T Uretero-arterial fistula: Six new cases and systematic review of the literature.
%A Ghouti C
%A Leon G
%A Seddik S
%A Ait Said K
%A Vaudreuil L
%A Tillou X
%J Prog Urol
%V 31
%N 10
%D Sep 2021
%M 34158218
%F 1.09
%R 10.1016/j.purol.2020.12.015
%X <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.<BR><B>UNASSIGNED: </B>3.