# Ureteroarterial fistula: Late infectious common iliac artery pseudoaneurysm formation following successful endovascular stenting and literature review

## TL;DR

A woman developed a serious infection after a successful procedure to fix a rare blood vessel-urinary tract connection, requiring further surgery.

## Contribution

Highlights the risk of late infectious pseudoaneurysm after endovascular stenting for ureteroarterial fistulas.

## Key findings

- Endovascular stenting for ureteroarterial fistulas may lead to infectious pseudoaneurysm formation.
- Collaboration among urologists, radiologists, and surgeons is crucial for managing these complex cases.
- Reintervention may be necessary in some patients despite initial successful stent placement.

## Abstract

The long‐term prognosis of endovascular stenting for ureteroarterial fistulas is not always favorable. We present a case in which endovascular repair of a ureteroarterial fistula led to the development of an infectious iliac artery pseudoaneurysm that required open vascular graft replacement 1 year later.

A 38‐year‐old woman with radiation‐induced vesicovaginal fistula and bilateral ureteral stenosis underwent urinary diversion using an ileal conduit. During left ureteral stent exchange, a ureteroarterial fistula occurred on the left side and was successfully treated with vascular stent grafting. One year later, gross hematuria recurred, requiring open surgical intervention because of the formation of an infectious pseudoaneurysm near the aortic bifurcation.

Several patients treated with stent grafting for ureteroarterial fistulas require subsequent reintervention. Urologists managing patients with ureteroarterial fistulas should collaborate closely with interventional radiologists and vascular surgeons to ensure comprehensive care.