Western Trauma Association
Management of Pelvic Fracture with Hemodynamic Instability
Annotation for Point O
One study of 556 patients undergoing pelvic angiography for
suspected arterial hemorrhage had an embolization rate of
47%. Subsequently 42 (7.5% of the total population) had
repeat angiography with embolization and successful
hemorrhage control.39
In one study of patients with complex pelvic fractures, not
responding to subselective embolization, multiple sources of
arterial hemorrhage were identified in 93%. Temporary
embolization (with gelatin sponge slurry) of both internal
iliac arteries was performed. This salvage maneuver was
successful in 90% and with repeat embolization of both
internal iliacs; a 97% success rate was achieved.40
Reported complications of bilateral internal iliac
embolization have included gluteal skin and muscle necrosis
with death from sepsis.41
