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. 2011:2011:935484.
doi: 10.1155/2011/935484. Epub 2011 Apr 19.

Clinical outcome of intra-arterial embolization for treatment of patients with pelvic trauma

M W Barentsz  1 , E P A Vonken, J A van Herwaarden, L P H Leenen, W P Th M Mali, M A A J van den Bosch
Affiliations

Clinical outcome of intra-arterial embolization for treatment of patients with pelvic trauma

M W Barentsz et al. Radiol Res Pract. 2011.

Abstract

Purpose. To analyse the technical success of pelvic embolization in our institution and to assess periprocedural hemodynamic status and morbidity/mortality of all pelvic trauma patients who underwent pelvic embolization. Methods. A retrospective analysis of patients with a pelvic fracture due to trauma who underwent arterial embolization was performed. Clinical data, pelvic radiographs, contrast-enhanced CT-scans, and angiographic findings were reviewed. Subsequently, the technical success and peri-procedural hemodynamic status were evaluated and described. Results. 19 trauma patients with fractures of the pelvis underwent arterial embolization. Initially, 10/19 patients (53%) were hemodynamically unstable prior to embolization. Technical success of embolization was 100%. 14/19 patients (74%) were stable after embolization, and treatment success was high as 74%. Conclusion. Angiography with subsequent embolization should be performed in patients with a pelvic fracture due to trauma and hemodynamic instability, after surgical intervention or with a persistent arterial blush indicative of an active bleeding on CT.

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Figures

Figure 1
Figure 1
(a) Contrast-enhanced CT scan of a patient with a type C pelvic fracture after trauma. The arrow indicating a hematoma. (b) Selective catheterization of a branch from the left internal iliac artery showing a contrast blush, indicating an active bleeding. (c) Catheterization of the left internal iliac artery after coil embolization of the actively bleeding branch, with absence of any contrast blush (arrow indicating the coil in situ).
Figure 2
Figure 2
Treatment algorithm. FAST: focused assessment with sonography for trauma; CTA: computed tomography angiography.
See this image and copyright information in PMC

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