Complications After Pelvic Arteriography in Patients With Pelvic Ring Disruptions

J Am Acad Orthop Surg. 2018 Nov 1;26(21):765-772. doi: 10.5435/JAAOS-D-17-00198.

Abstract

Introduction: Pelvic angiography with transcatheter arterial embolization (TAE) is an established intervention for management of pelvic arterial hemorrhage. This study analyzes complication rates after angiography among patients with pelvic trauma treated in the context of a multidisciplinary institutional pelvic fracture protocol.

Methods: Retrospective analysis of prospectively collected data was conducted. Demographics, fracture type, embolization (ie, unilateral versus bilateral and selective versus nonselective), and complications (ie, pseudoaneurysm, renal failure, soft-tissue necrosis/infection, and anaphylactic reactions) were noted.

Results: Eighty-one patients with pelvic ring injuries underwent angiography from 2009 to 2013. Complications among 41 patients who underwent angiography with TAE were compared with a control group of 40 patients who underwent angiography without TAE. Eight of 41 patients with TAE had complications (19.5%) compared with 3 of 40 (7.5%) in the control group (P = 0.19). The overall complication rate was 13.6%.

Conclusion: The use of angiography with TAE as part of an institutional pelvic fracture protocol involves an acceptable rate of complications.

Level of evidence: III.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography / adverse effects*
  • Clinical Protocols
  • Embolization, Therapeutic*
  • Female
  • Fractures, Bone / complications*
  • Fractures, Bone / diagnostic imaging*
  • Hemorrhage / diagnostic imaging*
  • Hemorrhage / etiology
  • Hemorrhage / therapy*
  • Humans
  • Male
  • Middle Aged
  • Pelvic Bones / injuries*
  • Retrospective Studies
  • Young Adult