Angiographic embolization of bilateral internal iliac arteries to control life-threatening hemorrhage after blunt trauma to the pelvis

G. C. Velmahos, S. Chahwan, S. E. Hanks, J. A. Murray, T. V. Berne, J. Asensio, D. Demetriades

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100 Scopus citations

Abstract

Angiographic embolization of bleeding pelvic vessels is increasingly used in patients with pelvic injuries. Temporary angiographic embolization of bilateral internal iliac arteries (TAEBIIA) is occasionally necessary. From November 1991 to March 1998, 30 consecutive patients (mean age of 43 years, mean Injury Severity Score of 25) with complex pelvic fractures underwent TAEBIIA to control severe hemorrhage not responding to subselective embolization. Angiography revealed multiple sources of pelvic bleeding in 28 (93%) patients. In the two remaining patients, no bleeding was identified but TAEBIIA was done empirically. Thirteen patients had laparotomies before TAEBIIA with unsuccessful bleeding control, and the remaining 17 had TAEBIIA as the primary treatment. After TAEBIIA 90 per cent of patients had successful clinical (27 of 30) and radiographic (25 of 28) control of bleeding. Of the three patients who continued to bleed after TAEBIIA two were successfully re-embolized and one died of acute cardiac failure before any further intervention was attempted. TAEBIIA had a success rate of 97 per cent (29 of 30) in controlling pelvic hemorrhage without significant complications related to it. TAEBIIA is a safe and effective alternative to subselective embolization in controlling retroperitoneal bleeding in selected patients with blunt pelvic trauma.

Original languageEnglish (US)
Pages (from-to)858-862
Number of pages5
JournalAmerican Surgeon
Volume66
Issue number9
StatePublished - Sep 13 2000
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery

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    Velmahos, G. C., Chahwan, S., Hanks, S. E., Murray, J. A., Berne, T. V., Asensio, J., & Demetriades, D. (2000). Angiographic embolization of bilateral internal iliac arteries to control life-threatening hemorrhage after blunt trauma to the pelvis. American Surgeon, 66(9), 858-862.