Key result
Endovascular embolization and stenting achieves successful hemostasis in rare ureterorectal-arterial fistula.
Why the study?
Late complications such as ureterorectal-arterial fistula and external iliac artery stenosis occur more frequently due to prolonged survival in recurrent endometrial cancer patients, requiring effective management strategies.
Case Report (n=1)
Endovascular treatment, including embolization and stent graft implantation, is a viable approach for managing surgically untreatable ureterorectal-arterial fistula and arterial stenosis caused by cancer invasion.
Endovascular embolization and angioplasty succeeded in this URAF case; leaves open its safety and efficacy as a standard option in recurrent cancer.
Owing to improvements in anticancer treatment, patients' overall survival has been prolonged, and late complications occur more frequently than previously. We successfully managed a case of ureterorectal-arterial fistula (URAF) and external iliac artery (EIA) stenosis due to endometrial cancer recurrence using an endovascular approach, including arterial embolization and angioplasty. The patient was a 48-year-old woman undergoing chemoradiotherapy for recurrent endometrial cancer following surgery and adjuvant chemotherapy. Tumor involvement and its response to treatment led to the development of URAF and EIA stenosis. Catastrophic bleeding occurred from URAF, and hemostasis was successfully achieved by left internal iliac artery embolization using a mixture of N-butyl cyanoacrylate and ethiodized oil. Nine days after embolization, angioplasty was performed using a stent graft implantation for EIA stenosis. Endovascular treatment is considered a crucial approach for managing both URAF and arterial stenosis, which is surgically untreatable.
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Yoshikawa et al. (2025) conducted a case report in Ureterorectal-arterial fistula and external iliac artery stenosis due to recurrent endometrial cancer (n=1). Endovascular treatment (arterial embolization and angioplasty with stent graft) was evaluated on Hemostasis and management of arterial stenosis. Endovascular treatment, including arterial embolization and stent graft implantation, successfully achieved hemostasis and managed arterial stenosis in a patient with a ureterorectal-arterial fistula.
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