V08_No_3_Final.pdf


Pictorial Urology

177Urology Journal    Vol 8    No 3    Summer 2011

Ureteral Obstruction and Stent Thrombosis After 
Endovascular Treatment of Iliac Artery Aneurysm

A 36-year-old man presented with asymptomatic ureteral obstruction incidentally discovered in a 
routine health examination. His only past surgical history included an endovascular stenting of a 
right inflammatory common iliac artery aneurysm 12 years earlier. However, the patient did not take 
anticoagulant therapy regularly due to noncompliance.

Magnetic resonance imaging revealed a normal left kidney and grade III hydronephrosis of both 
segments of the right duplex kidney with a bifid ureter joining further distal to the kidney. Retrograde 
pyelography showed obstruction of the right ureter at the level of crossing with the right common iliac 
artery (RCIA) with the stent in situ. Computed tomography scan demonstrated a totally thrombosed 
RCIA and peri-arterial fibrosis, causing proximal ureteral dilatation and hydronephrosis.

The patient underwent a right nephroureterectomy for nonfunctioning duplex kidney. The completely 
thrombosed stent was removed in the same session. The collateral circulation to the lower limb was 
sufficient to maintain normal motor function and viability of the leg. 

Premature anticoagulant therapy discontinuation was identified as predictors of thrombotic events. To 
the best of our knowledge, this is the first report of ureteral obstruction and stent thrombosis following 
endovascular stenting of RCIA.

With the increasing frequency of endovascular treatment of the iliac artery aneurysm, we must become 
aware of potential complications associated with these procedures.(1,2)

Long Wang, Lin Qi, Zhengyan Tang*
Department of Urology, Xiangya Hospital, Central South University, China

*E-mail: xyurology@yahoo.com.cn

REFERENCES
1. Metcalfe MJ, Hanna MS, Gill S, Burfitt NJ, Mitchell AW, Franklin IJ. Hydronephrosis after embolization of internal iliac artery 

aneurysms. J Vasc Interv Radiol. 2010;21:571-3.

2. Ozturk MH, Eyuboglu I, Pulathan Z, Dinc H. Spontaneous thrombosis of a saccular iliac artery aneurysm induced by 
overlapping self-expandable bare metallic stents. Diagn Interv Radiol. 2010;16:308-11.

Urol J. 2011;8:177. 
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