Imaging and Endovascular Treatment of Bleeding Pelvic Fractures: Review Article

Cardiovasc Intervent Radiol. 2019 Jan;42(1):10-18. doi: 10.1007/s00270-018-2071-4. Epub 2018 Sep 17.

Abstract

Pelvic fractures are potentially life-threatening injuries with high mortality rates, mainly due to intractable pelvic arterial bleeding. However, concomitant injuries are frequent and may also be the cause of significant blood loss. As treatment varies depending on location and type of hemorrhage, timely imaging is of critical importance. Contrast-enhanced CT offers fast and detailed information on location and type of bleeding. Angiography with embolization for pelvic fracture hemorrhage, particularly when performed early, has shown high success rates as well as low complication rates and is currently accepted as the first method of bleeding control in pelvic fracture-related arterial hemorrhage. In the current review imaging workup, patient selection, technique, results and complications of pelvic embolization are described.

Keywords: Embolization; Imaging; Pelvic fracture; Trauma.

MeSH terms

  • Adult
  • Angiography / methods*
  • Embolization, Therapeutic / methods*
  • Female
  • Fractures, Bone / complications
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / therapy*
  • Guideline Adherence
  • Hemorrhage / diagnostic imaging
  • Hemorrhage / therapy*
  • Humans
  • Male
  • Middle Aged
  • Patient Selection
  • Pelvic Bones / blood supply
  • Pelvic Bones / diagnostic imaging
  • Pelvic Bones / injuries*
  • Tomography, X-Ray Computed