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European Radiology

Erschienen in:

09.06.2020 | Vascular-Interventional

Pelvic Trauma: factors predicting arterial hemorrhage and the role of Angiography and preperitoneal pelvic packing

verfasst von: Jagteshwar Sandhu, Robert Abrahams, Zoe Miller, Shivank Bhatia, Tanya L Zakrison, Prasoon Mohan

Erschienen in: European Radiology | Ausgabe 11/2020

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Abstract

Objectives

(1) To identify the factors predicting arterial extravasation in pelvic trauma and (2) to assess the efficacy of preperitoneal pelvic packing (PPP) in controlling arterial hemorrhage.

Methods

Institutional review board approved the retrospective study of 139 consecutive pelvic trauma patients who underwent angiographic intervention with or without prior PPP between January 2011 and December 2016. Patient demographics and presenting characteristics were recorded. Both groups of patients were combined for analysis of predictors for arterial extravasation using univariate logistic regression followed by multivariate logistic regression. Significance level was defined as p < 0.05.

Results

Forty-nine out of 139 patients had PPP prior to pelvic angiogram. Embolization was performed in 85 (61.2%) patients and the technical and clinical success rate was 100%. Sixty-nine (49.7%) patients had unstable Young-Burgess (Y&B) type fractures, of which 58% had arterial hemorrhage compared with 38.6% of those with stable Y&B fractures (p = 0.02). Of the patients who had PPP prior to angiogram, 28(57.1%) continued to have arterial extravasation on subsequent angiography. Unstable Y&B type fractures are independent predictors of arterial hemorrhage (OR 2.3, 95%CI 1.1 to 4.7, p = 0.02).

Conclusion

Unstable Y&B type pelvic fractures are predictors of arterial extravasation. PPP alone is not effective for arterial hemorrhage control in pelvic trauma. Angiographic intervention remains a minimally invasive and definitive treatment of arterial hemorrhage from pelvic trauma.

Key Points

• Unstable Young-Burgess pelvic fractures are predictors of arterial hemorrhage in pelvic trauma.

• Pelvic angiography and embolization should precede PPP wherever feasible.

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Titel: Pelvic Trauma: factors predicting arterial hemorrhage and the role of Angiography and preperitoneal pelvic packing
verfasst von: Jagteshwar Sandhu
Robert Abrahams
Zoe Miller
Shivank Bhatia
Tanya L Zakrison
Prasoon Mohan
Publikationsdatum: 09.06.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 11/2020
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-06965-9

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Pelvic Trauma: factors predicting arterial hemorrhage and the role of Angiography and preperitoneal pelvic packing