Semin intervent Radiol 2020; 37(01): 044-054
DOI: 10.1055/s-0039-3401839
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Interventional Radiology in Pelvic Trauma

Derek F. Franco
1   Department of Radiology, University of Chicago Medicine, Chicago, Illinois
,
Steven M. Zangan
1   Department of Radiology, University of Chicago Medicine, Chicago, Illinois
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
04. März 2020 (online)

Abstract

Traumatic pelvic injuries are associated with high injury severity scores and significant morbidity and mortality. As fractures and ligamentous disruption result in increased pelvic volume, retroperitoneal hemorrhage can spiral and progress to hemorrhagic shock. Due to the extensive collateral supply and limitations of surgery for pelvic hematomas, angiographic treatment is at the forefront of pelvic trauma management. This article will discuss typical injuries seen in pelvic trauma, treatment modalities available to the interventional radiologist, and common angiographic treatment strategies and techniques.

 
  • References

  • 1 Heron M. Deaths: leading causes for 2017. Natl Vital Stat Rep 2019; 68 (06) 1-77
  • 2 Verbeek DO, Zijlstra IA, van der Leij C, Ponsen KJ, van Delden OM, Goslings JC. Management of pelvic ring fracture patients with a pelvic “blush” on early computed tomography. J Trauma Acute Care Surg 2014; 76 (02) 374-379
  • 3 Yoon W, Kim JK, Jeong YY, Seo JJ, Park JG, Kang HK. Pelvic arterial hemorrhage in patients with pelvic fractures: detection with contrast-enhanced CT. Radiographics 2004; 24 (06) 1591-1605 , discussion 1605–1606
  • 4 Yao DC, Jeffrey Jr RB, Mirvis SE. , et al. Using contrast-enhanced helical CT to visualize arterial extravasation after blunt abdominal trauma: incidence and organ distribution. AJR Am J Roentgenol 2002; 178 (01) 17-20
  • 5 Geschwind J-FH, Dake MD. Angiographic Management of Hemorrhage in Pelvic Fractures. In: Abrams' Angiography Interventional Radiology. Philadelphia, PA: Lippincott Williams & Wilkins; 2014: 841-851
  • 6 Patterson FP, Morton KS. The cause of death in fractures of the pelvis: with a note on treatment by ligation of the hypogastric (internal iliac) artery. J Trauma 1973; 13 (10) 849-856
  • 7 Brotman S, Soderstrom CA, Oster-Granite M, Cisternino S, Browner B, Cowley RA. Management of severe bleeding in fractures of the pelvis. Surg Gynecol Obstet 1981; 153 (06) 823-826
  • 8 Yellin AE, Lundell CJ, Finck EJ. Diagnosis and control of posttraumatic pelvic hemorrhage. Transcatheter angiographic embolization techniques. Arch Surg 1983; 118 (12) 1378-1383
  • 9 Stock JR, Harris WH, Athanasoulis CA. The role of diagnostic and therapeutic angiography in trauma to the pelvis. Clin Orthop Relat Res 1980; (151) 31-40
  • 10 Kaufman JA, Lee MJ. Abdominal aorta and pelvic arteries. In: The Requisites: Vascular and Interventional Radiology. Philadelphia, PA: Saunders; 2014: 199-228
  • 11 Vassiliu P, Sava J, Toutouzas KG, Velmahos GC. Is contrast as bad as we think? Renal function after angiographic embolization of injured patients. J Am Coll Surg 2002; 194 (02) 142-146
  • 12 Ray CE, Waltman AC. General principles of embolization and chemoembolization. In: Vascular and Interventional Radiology: Principles and Practice, 1st ed. New York: Thieme; 2002: 89-100
  • 13 Hak DJ. The role of pelvic angiography in evaluation and management of pelvic trauma. Orthop Clin North Am 2004; 35 (04) 439-443 , v
  • 14 Papakostidis C, Kanakaris N, Dimitriou R, Giannoudis PV. The role of arterial embolization in controlling pelvic fracture haemorrhage: a systematic review of the literature. Eur J Radiol 2012; 81 (05) 897-904
  • 15 Ben-Menachem Y, Coldwell DM, Young JWR, Burgess AR. Hemorrhage associated with pelvic fractures: causes, diagnosis, and emergent management. AJR Am J Roentgenol 1991; 157 (05) 1005-1014
  • 16 Huittinen V-M, Slätis P. Postmortem angiography and dissection of the hypogastric artery in pelvic fractures. Surgery 1973; 73 (03) 454-462
  • 17 Tisnado J, Ivatury RR. Interventional radiology in pelvic trauma. In: Interventional Radiology in Trauma Management. New York, NY: Thieme; 2016: 168-172
  • 18 Kam J, Jackson H, Ben-Menachem Y. Vascular injuries in blunt pelvic trauma. Radiol Clin North Am 1981; 19 (01) 171-186
  • 19 Matalon TS, Athanasoulis CA, Margolies MN. , et al. Hemorrhage with pelvic fractures: efficacy of transcatheter embolization. AJR Am J Roentgenol 1979; 133 (05) 859-864
  • 20 Hallinan JT, Tan CH, Pua U. Emergency computed tomography for acute pelvic trauma: where is the bleeder?. Clin Radiol 2014; 69 (05) 529-537
  • 21 Miller PR, Moore PS, Mansell E, Meredith JW, Chang MC. External fixation or arteriogram in bleeding pelvic fracture: initial therapy guided by markers of arterial hemorrhage. J Trauma 2003; 54 (03) 437-443
  • 22 Katz MD, Teitelbaum GP, Pentecost MJ. Diagnostic arteriography and therapeutic transcatheter embolization for post-traumatic pelvic hemorrhage. Semin Intervent Radiol 1992; 9: 4-12
  • 23 Stern JR, Elmously A, Smith MC. , et al. Transradial interventions in contemporary vascular surgery practice. Vascular 2019; 27 (01) 110-116
  • 24 Mason PJ, Shah B, Tamis-Holland JE. , et al; American Heart Association Interventional Cardiovascular Care Committee of the Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Peripheral Vascular Disease; and Council on Genomic and Precision Medicine. An update on radial artery access and best practices for transradial coronary angiography and intervention in acute coronary syndrome: a scientific statement from the American Heart Association. Circ Cardiovasc Interv 2018; 11 (09) e000035
  • 25 Adnan SM, Romagnoli AN, Madurska MJ, DuBose JJ, Scalea TM, Morrison JJ. Safety and efficacy of radial access for the management of endovascular trauma. J Vasc Surg 2019; 69 (06) 52-53
  • 26 Bernat I, Abdelaal E, Plourde G. , et al. Early and late outcomes after primary percutaneous coronary intervention by radial or femoral approach in patients presenting in acute ST-elevation myocardial infarction and cardiogenic shock. Am Heart J 2013; 165 (03) 338-343
  • 27 Seto AH, Roberts JS, Abu-Fadel MS. , et al. Real-time ultrasound guidance facilitates transradial access: RAUST (Radial Artery access with Ultrasound Trial). JACC Cardiovasc Interv 2015; 8 (02) 283-291
  • 28 Yamada R, Guimaraes M, Schonholz C. Vascular trauma: be ready for anything. Endovascular Today 2016; 15 (01) 50-55
  • 29 Schrumpf JD, Sommer G, Jacobs RP. Bleeding simulated by the distal internal pudendal artery stain. AJR Am J Roentgenol 1978; 131 (04) 657-659
  • 30 Velmahos GC, Chahwan S, Hanks SE. , et al. Angiographic embolization of bilateral internal iliac arteries to control life-threatening hemorrhage after blunt trauma to the pelvis. Am Surg 2000; 66 (09) 858-862
  • 31 Jeske HC, Larndorfer R, Krappinger D. , et al. Management of hemorrhage in severe pelvic injuries. J Trauma 2010; 68 (02) 415-420
  • 32 Rasuli P, Moosavi B, French GJ, Petrcich W, Hammond I. Splenic artery embolization in blunt trauma: a single-center retrospective comparison of the use of gelatin sponge versus coils. AJR Am J Roentgenol 2017; 209 (06) W382-W387
  • 33 Lopera JE. Embolization in trauma: principles and techniques. Semin Intervent Radiol 2010; 27 (01) 14-28
  • 34 Balogh Z, Vörös E, Süveges G, Simonka JA. Stent graft treatment of an external iliac artery injury associated with pelvic fracture. A case report. J Bone Joint Surg Am 2003; 85 (05) 919-922