Arterial Embolization is a Rapid and Effective Technique for Controlling Pelvic Fracture Hemorrhage.

Authors

Stefano F. Agolini MD, Lehigh Valley Health NetworkFollow
Kamalesh T. Shah MD, Lehigh Valley Health NetworkFollow
James Jaffe MD, Lehigh Valley Health NetworkFollow
James A. Newcomb MD, Lehigh Valley Health NetworkFollow
Michael Rhodes MD, FACS, Lehigh Valley Health NetworkFollow
James F. Reed III, PhD, Lehigh Valley Health NetworkFollow

Publication/Presentation Date

9-1-1997

Abstract

OBJECTIVE: To review the success rate of embolization in stopping hemorrhage for unstable patients with severe pelvic fractures, to calculate the time to achieve embolization, and to determine the yield from angiography.

DESIGN: Retrospective review of patients admitted to a Level I trauma center with pelvic fractures during a 5-year period.

MATERIALS AND METHODS: Charts were reviewed for Injury Severity Score, age, blood pressure, prothrombin time/partial thromboplastin time, pelvic fracture type, mortality, time to reach the angiography suite, time to achieve embolization, and mechanism of injury.

MEASUREMENTS AND MAIN RESULTS: Of 806 patients admitted with pelvic fractures, 35 underwent pelvic angiography, and 15 (1.9%) required embolization. Embolization was successful for all patients. No deaths resulted from ongoing hemorrhage. Angiography yield in initially unstable patients was 64%. The mean age and initial hemodynamic instability were significantly greater in nonsurvivors. The time from arrival in the trauma bay to arrival in the angiography suite ranged from 50 to 1,140 minutes, and the time spent in the angiography suite performing embolization ranged from 50 to 140 minutes, with an average time of 90 minutes. Patients who were embolized within 3 hours of arrival had a significantly greater survival rate.

CONCLUSION: Only a small percentage of patients with pelvic fractures require embolization, but when it is used, embolization can be 100% effective. Age, time to achieve embolization, and initial hemodynamic instability appear to be important factors in survival.

Volume

43

Issue

3

First Page

395

Last Page

399

ISSN

0022-5282

Published In/Presented At

Agolini, S. F., Shah, K., Jaffe, J., Newcomb, J., Rhodes, M., & Reed, J. 3. (1997). Arterial embolization is a rapid and effective technique for controlling pelvic fracture hemorrhage. The Journal Of Trauma, 43(3), 395-399.

Disciplines

Medicine and Health Sciences | Other Medical Specialties | Radiology | Surgery | Trauma

PubMedID

9314298

Department(s)

Department of Community Health and Health Studies, Department of Medicine, Department of Radiology and Diagnostic Medical Imaging, Department of Surgery, Department of Surgery Faculty

Document Type

Article