Imaging and Endovascular Treatment of Bleeding Pelvic Fractures: Review Article

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,...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 2019-01, Vol.42 (1), p.10-18
Main Authors: Wijffels, Diederik J., Verbeek, Diederik O., Ponsen, Kornelis J., Carel Goslings, J., van Delden, Otto M.
Format: Article
Language:English
Subjects:
Adult
Angiography
Angiography - methods
BIOMEDICAL RADIOGRAPHY
Bleeding
BLOOD
BLOOD VESSELS
Cardiology
Cardiovascular system
Complications
Computed tomography
COMPUTERIZED TOMOGRAPHY
Contrast agents
Embolization
Embolization, Therapeutic - methods
Female
Fractures
Fractures, Bone - complications
Fractures, Bone - diagnostic imaging
Fractures, Bone - therapy
Guideline Adherence
HEMORRHAGE
Hemorrhage - diagnostic imaging
Hemorrhage - therapy
Humans
Imaging
INJURIES
Male
Medicine
Medicine & Public Health
Middle Aged
MORTALITY
Nuclear Medicine
Patient Selection
PATIENTS
Pelvic Bones - blood supply
Pelvic Bones - diagnostic imaging
Pelvic Bones - injuries
PELVIS
Radiology
RADIOLOGY AND NUCLEAR MEDICINE
Review
Tomography, X-Ray Computed
Ultrasound
VASCULAR DISEASES
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Description
Summary: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.
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-018-2071-4