Update on the roles of angiography and embolisation in pelvic fracture

Trauma accounts for approximately 1 in 10 deaths worldwide. The presence of a pelvic fracture increases this mortality risk. Successful management depends on accurate diagnostic staging and control of fracture-related haemorrhage. From the standpoint of the trauma surgeon, this necessitates thorough compression and stabilisation of the fracture using external compression, combined with retroperitoneal or preperitoneal packing. However, vascular injury in many parts of the body can preferentially and effectively be treated on an emergency basis with angiographic procedures, using superselective embolisation in combination with other interventional techniques. The option of combining open surgery and angiographic methods should be kept in mind, but there are no uniform guidelines. In the literature, numerous studies and reports have documented the feasibility of interventional radiological procedures in trauma cases with pelvic fracture. Thus all level I trauma centres should be able to provide this service on a 24h basis.