PMC5073222_01
Right antegrade nephrostogram (posterior view) showing right hydroureteronephrosis proximal to right Memokath 051 .
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A right nephrostomy was placed and nephrostogram confirmed obstruction at level of upper end of the stent (Fig. 1).
CT 3D reconstruction of right ureteroexternal iliac artery fistula and right ureteropresacral space fistula communicating to perineal sinus. Green: contrast in presacral bed draining through perineal sinus, pink: contrast in bladder, yellow: Memokath 051 stent.
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Urgent CT angiogram revealed a complex fistula between the right distal ureter and both the presacral sinus and the right external iliac artery adjacent to the Memokath with extensive bladder clots (Fig. 2).
Formal angiogram showing right ureteroexternal iliac artery fistula adjacent to Memokath 051 stent.
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Formal angiogram confirmed the fistula and showed a false aneurysm of the right external iliac artery complicating the fistula (Fig. 3).
Formal angiogram after insertion of self-expanding stent shows resolution of right ureteroexternal iliac artery fistula.
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A 16 mm self-expanding covered vascular stent was deployed to bridge the external iliac artery fistula site (Fig. 4).