1. The Role of Transcatheter Arterial Embolization in Traumatic Pelvic Hemorrhage: Not Only Pelvic Fracture
- Author
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Alessio Comai, Giampietro Bonatti, Marianna Zatelli, and Thomas Haglmuller
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,embolization ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,interventional radiology ,Medicine ,Embolization ,medicine.diagnostic_test ,business.industry ,Arterial Embolization ,General Engineering ,pelvic fractures ,030208 emergency & critical care medicine ,Interventional radiology ,medicine.disease ,Surgery ,body regions ,Orthopedics ,trauma ,Blunt trauma ,Angiography ,Pelvic fracture ,Radiology ,hemorrhage ,Presentation (obstetrics) ,business ,Complication - Abstract
Purpose: The most common life-threatening complication of pelvic trauma is bleeding. Arterial bleedings frequently require active management, preferably with transcatheter arterial embolization (TAE). Hemodynamic instability and/or contrast extravasation at computer tomography (CT) examination are reliable indicators of arterial injury. Unstable pelvic fractures are much more hemorrhagic than stable fractures. Nevertheless, an absent or isolated pelvic fracture does not exclude pelvic hemorrhage. Materials and Methods: A retrospective study was conducted on our institutional database by collecting data of patients who underwent pelvic angiography and/or embolization due to pelvic blunt trauma in the period between August 2010 and August 2015. Results: In a period of five years, 39 patients with traumatic pelvic bleeding underwent angiography at our institution. Thirty-six of the 39 (92%) patients did show CT signs of active pelvic bleeding. Nineteen of 39 (49%) patients were hemodynamically unstable at presentation. Three of the 39 patients did not require embolization. Technical success was 35/36 (97%), and overall mortality was 3/39 (8%). Notably, 5/39 (13%) patients did not have any pelvic fracture at presentation, and 18/39 (46%) had only isolated or stable pelvic ring fracture. Conclusions: TAE is an effective technique to treat arterial pelvic bleeding after trauma. The absence of a major pelvic fracture does not exclude the risk of active bleeding requiring prompt treatment.
- Published
- 2016
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