Percutaneous transcatheter embolization for massive bleeding from pelvic fractures

Area of Science:

• Interventional Radiology
• Trauma Surgery
• Emergency Medicine

Background:

• Pelvic fractures can cause life-threatening hemorrhage.
• Retroperitoneal hematomas associated with pelvic fractures are challenging to manage.
• Transcatheter embolization is an option for hemorrhage control.

Purpose of the Study:

• To evaluate the effectiveness of transcatheter embolization for massive pelvic retroperitoneal hemorrhage.
• To assess the impact of early embolization on transfusion requirements and complications.

Main Methods:

• Prospective study of 31 patients with pelvic fractures, hypotension, and large retroperitoneal hematomas.
• Indications for angiography included significant blood transfusion requirements or unstable patients.
• Percutaneous transcatheter embolization was performed to control hemorrhage.

Main Results:

• Successful embolization achieved complete hemorrhage control in 87.1% of patients (27/31).
• Overall mortality was 35.5%, mainly due to associated injuries.
• Early embolization was associated with reduced transfusion needs.

Conclusions:

• Percutaneous transcatheter embolization is the procedure of choice for massive pelvic retroperitoneal hemorrhage.
• Early embolization is imperative in reducing transfusion requirements and associated complications.
• Transcatheter embolization offers a high success rate for controlling hemorrhage in severe pelvic trauma.