Percutaneous transcatheter embolization in multiply injured patients with pelvic ring disruption associated with severe haemorrhage and coagulopathy.
Six multiply injured patients with pelvic fractures were treated by percutaneous transcatheter embolization during a 10 month period. Diagnosis and therapy were carried out early in two cases (first day of admission into the trauma unit). Three patients were treated on the second day after admission. The last patient was embolized on the third day. Two patients underwent one and two remote embolizations. Embolization was indicated due to uncontrolled haemorrhaging, requiring large volumes of packed erythrocytes (median: 11.3) and fresh frozen plasma units (median: 6.8). Three patients had severe coagulopathy (disseminated intravascular coagulation). From two to 12 arteries were embolized per patient (median: 5). After successful transcatheter embolization, the circulation and coagulation stabilized rapidly without recurrence of haemorrhage or coagulopathy.
Piotin
M
M
Department of Neuroradiology and Therapeutic Angiography, Hôpital Lariboisière, Paris, France.
Herbreteau
D
D
Guichard
J P
JP
Houdart
E
E
Reizine
D
D
Aymard
A
A
Payen
D
D
Merland
J J
JJ
D000328:Adult; D004211:Disseminated Intravascular Coagulation / Q000209:etiology / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D050723:Fractures, Bone / Q000150:complications*; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications*; D010384:Pelvic Bones / Q000293:injuries*