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Ureteral stenosis following iliac artery stenting

Sachinder S Hans1, Mary M Lee1, Nitin Jain2

  • 1Department of Vascular Surgery, Henry Ford Macomb Hospital, Clinton Township, Mich.

Journal of Vascular Surgery Cases and Innovative Techniques
|September 14, 2020
PubMed

Insights

Ureteral stenosis, a rare complication of endovascular iliac artery repair, can occur due to persistent fibrosis around iliac stents. This case highlights the potential for ureteral injury following these interventions.

Area of Science:

  • Vascular Surgery
  • Urology
  • Interventional Radiology

Background:

  • Ureteral complications are known sequelae of open aortoiliac reconstruction.
  • Endovascular interventions for iliac artery disease are generally associated with lower rates of ureteral complications.

Observation:

  • A case of left ureteral stenosis leading to hydroureteronephrosis is presented.
  • The patient had undergone multiple endovascular interventions on the left common and external iliac arteries.
  • Intraoperative robotic ureterolysis revealed significant peri-iliac fibrosis and scarring near the iliac stents.

Findings:

  • Iliac stenting, despite being an endovascular approach, can lead to ureteral stenosis.
  • Persistent peri-iliac fibrosis and scarring around stents are implicated in the pathogenesis of ureteral complications.

Implications:

  • Clinicians should maintain a high index of suspicion for ureteral complications in patients with a history of multiple iliac interventions.
  • Awareness of this potential complication is crucial for timely diagnosis and management.
  • Further research may be warranted to elucidate the precise mechanisms and identify preventative strategies.

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