Details

Autor(en) / Beteiligte

• Ierardi, Anna Maria
• Piacentino, Filippo
• Fontana, Federico
• Petrillo, Mario
• Floridi, Chiara
• Bacuzzi, Alessandro
• Cuffari, Salvatore
• Elabbassi, Wael
• Novario, Raffaele
• Carrafiello, Gianpaolo

Titel

The role of endovascular treatment of pelvic fracture bleeding in emergency settings

Ist Teil von

• European radiology, 2015-07, Vol.25 (7), p.1854-1864

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2015

Quelle

MEDLINE

Beschreibungen/Notizen

• Purpose To evaluate the role of endovascular treatment for controlling haemorrhage in haemodynamically unstable patients with pelvic bone fractures and to relate clinical efficacy to pre-procedural variables. Materials and Methods From March 2009 through April 2013, 168 patients with major pelvic trauma associated with high-flow haemorrhage were referred to our emergency department and were retrospectively reviewed. Pelvic arteries involved were one or more per patient. Embolisation was performed using various materials (micro-coils, Spongostan, plug, glue, covered stent), and technical success, complications, treatment success, clinical efficacy, rebleeding, and mortality rates were assessed. Factors influencing clinical efficacy were also evaluated. Results The technical success rate was 100 %; no complications occurred during the procedures. Treatment was successful in 94.6 % cases, and clinical efficacy was 85.7 %. Three patients had to undergo a second arteriography due to recurrent haemorrhage. Fifteen patients died. Pre-embolisation transfusion demand was significantly associated with clinical efficacy. Conclusions Percutaneous embolisation of pelvic bleeding may be considered a safe, effective, and minimally invasive therapeutic option. As haemodynamic stability is the first objective with traumatic haemorrhagic patient, arterial embolisation can assume a primary role. On the basis of our results, pre-procedural transfusion status may be considered a prognostic factor. Key Points • The series presented is one of the largest in a single centre. • Arterial embolisation is a life-saving procedure in patients with pelvic haemorrhage. • In pelvic traumas associated with haemorrhage, prognosis is dependent upon prompt treatment. • Transfusion status is significantly related to clinical efficacy.