J Korean Soc Radiol.  2009 Nov;61(5):311-318. 10.3348/jksr.2009.61.5.311.

Transarterial Embolization of Arterial Bleeding in Patients with Pelvic Bone Fractures

• Song JS
• Kwak HS
• Han YM

• KMID: 2026172
• DOI: http://doi.org/10.3348/jksr.2009.61.5.311

Abstract

PURPOSE
This study was designed to evaluate the usefulness of transcatheter arterial embolization (TAE) in hemodynamically unstable patients with a pelvic bone fracture.
MATERIALS AND METHODS
From November 2004 to July 2007, we retrospectively reviewed 211 patients with pelvic bone fractures. Of these patients, 24 patients with CT findings of active bleeding or hemodynamic instability underwent pelvic angiography. There were 13 female and 11 male patients, with an age range from 21 to 92 years (mean age, 58.3 years). To evaluate arterial injuries, angiography was performed, followed by TAE using coils, gelfoams and N-butyl-2-cyanoacrylate. The evaluation of risk factors between patients who were still alive and patients who had expired was performed statistically by use of the Student's t test and chisquared analysis.
RESULTS
A total of 28 TAE procedures were performed in 24 patients and 50 injured arteries were occluded. Six patients (25%) died due to hypovolemic shock within 47 hours. Five of the patients were hemodynamically unstable (BP below 76/56 mmHg) prior to the angiographic procedure and one patient had a pseudoaneurysm located at the superior mesenteric artery. Dopamine usage and blood pressure before the procedure for patients showed a statistically significant difference between patients were still alive and patients who had expired (p = 0.01, p = 0.001).
CONCLUSION
TAE is a safe and effective treatment for an arterial injury of a pelvic bone fracture. The outcome of patients with a hemodynamically unstable state before TAE is poor.

MeSH Terms

Aneurysm, False
Angiography
Arteries
Blood Pressure
Dopamine
Embolization, Therapeutic
Enbucrilate
Female
Fractures, Bone
Gelatin Sponge, Absorbable
Hemodynamics
Hemorrhage
Humans
Male
Mesenteric Artery, Superior
Pelvic Bones
Retrospective Studies
Risk Factors
Shock
Dopamine
Enbucrilate