Open Access

RESIDENT’S CORNER

Embolization with Tornado coils to control bleeding from an arterioureteral fistula

Bruce L. Jacobs, Jodi K. Maranchie

Department of Urology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, USA
Address correspondence to Dr. Bruce L. Jacobs, Department of Urology, University of Pittsburgh Medical Center, 3471 Fifth Avenue, Suite 700, Pittsburgh, PA 15213 USA

Canadian Journal of Urology 2007, 14(6), 3770-3772.

Abstract

Arterioureteral fistulae are rare, but potentially life-threatening causes of bleeding. We present a case of an 82 year-old woman with refractory, transfusion-dependent bleeding from an arterial fistula to her right ureteral stump, following right radical nephrectomy for advanced renal cell carcinoma. Cystoscopy with retrograde ureteral stump embolization using Tornado (Cook Medical, Bloomington, Indiana, USA) coils plus a slurry of thrombin-soaked Gelfoam (Pfizer Inc., New York, New York, USA) was performed, which led to prompt resolution of the patient’s hematuria requiring no further hospitalizations or transfusions. Retrograde insertion of coils and injection of thrombin-soaked Gelfoam can be a minimally invasive, safe, and durable alternative for controlling hemorrhage from an arterioureteral fistula to a ureteral stump.

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