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[Complications following transcatheter arterial embolization for massive hemorrhage associated with pelvic fracture]
1Department of Radiology, Faculty of Medicine, Kagoshima University.
Insights
Internal iliac artery embolization for pelvic fracture hemorrhage is safe. Most complications are linked to the pelvic fracture itself, not the embolization procedure.
Area of Science:
- Interventional Radiology
- Vascular Surgery
- Trauma Surgery
Context:
- Massive hemorrhage from pelvic fractures presents a significant clinical challenge.
- Internal iliac artery embolization is a critical intervention for managing such bleeding.
Purpose:
- To evaluate the complications associated with internal iliac artery embolization in patients with pelvic fractures.
- To determine if observed complications are attributable to the embolization procedure or the underlying trauma.
Summary:
- A study of 21 patients (9 male, 12 female) undergoing internal iliac artery embolization for pelvic fracture hemorrhage was conducted.
- Embolization utilized gelfoam cubes, with prior use of steel coils noted.
- Complications included impotence (4/9 males), sensory disturbance (4/21), gait disturbance (8/21), dysuria (3/21), and defecation difficulty (1/21).
Impact:
- The study suggests that complications following internal iliac artery embolization are more likely due to associated injuries from pelvic fractures than the vascular occlusion itself.
- Percutaneous transcatheter therapeutic embolization is confirmed as a safe and effective primary treatment for life-threatening bleeding in pelvic fractures.
Abstract:
Complications of internal iliac artery embolization were studied in 21 patients. The 9 male and 12 female patients were 12-70 years old (average 39). This procedure was carried out for control of hemorrhage due to pelvic fracture. Embolization was performed using gelfoam cubes (1-2 mm) for main internal iliac artery or its branches subselectively. In the earlier series, steel coils were placed in the internal iliac artery routinely after gelfoam embolization. In the group of 9 men, 4 male had impotence and 5 had no change in sexual function. As a possible post embolization neurological damage, 4 patients had sensory disturbance and 8 patients had gait disturbance. Three patients had dysuria and one of them had also difficulty in defecation. All these complications following internal iliac artery embolization are suspected to be due to associated injuries and varied effect of traumatic pelvic fracture than a result of the vascular occlusion. Percutaneous transcatheter therapeutic embolization is a safe and effective procedure of choice for controlling massive bleeding associated with pelvic fracture.