Pseudoaneurysm associated with an arteriovesical fistula after bladder substitution surgery definitively treated with a covered stent: a report of 3 cases

Vasc Endovascular Surg. 2013 Nov;47(8):652-5. doi: 10.1177/1538574413500724. Epub 2013 Aug 22.

Abstract

A fistula between the iliac artery and a bladder pouch is a rare but potentially life-threatening condition. In 3 patients presenting with massive hematuria after urinary diversion, an iliac artery pseudoaneurysm was found on imaging studies. These pseudoaneurysms were considered to be associated with a fistula between artery and pouch, causing the hematuria. All patients were successfully treated with a covered stent to exclude the pseudoaneurysm and the arteriovesical fistula. Clinical follow-up of 10 weeks, 16 months, and 27 months, respectively, showed no residual hematuria. In addition, no clinical signs of stent graft infection or thrombosis were identified during follow-up. In conclusion, the placement of a covered stent is a valuable therapeutic treatment option in the management of hematuria due to an arteriovesical fistula after urinary diversion surgery.

Keywords: artery; fistula; pseudoaneurysm; stent graft.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aneurysm, False / diagnosis
  • Aneurysm, False / etiology
  • Aneurysm, False / therapy*
  • Endovascular Procedures / instrumentation*
  • Female
  • Hematuria / etiology
  • Humans
  • Iatrogenic Disease*
  • Iliac Artery / diagnostic imaging
  • Iliac Artery / injuries*
  • Male
  • Middle Aged
  • Stents*
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Urinary Bladder Fistula / diagnosis
  • Urinary Bladder Fistula / etiology
  • Urinary Bladder Fistula / therapy*
  • Urinary Diversion / adverse effects*
  • Vascular System Injuries / diagnosis
  • Vascular System Injuries / etiology
  • Vascular System Injuries / therapy*