Evaluation of short-term and long-term complications after emergent internal iliac artery embolization in patients with pelvic trauma.
OBJECTIVE
To assess the incidence of long- and short-term complications following internal iliac artery (IIA) embolization after blunt pelvic trauma.


METHODS
One hundred trauma patients with pelvic fractures underwent pelvic angiography from 1994 through 2006. Sixty-seven patients underwent IIA embolization. These patients were retrospectively identified for medical record review. Short- and long-term complications were defined as those occurring at less than or greater than 30 days, respectively. Complications and outcomes were assessed through chart review and, when possible, a standardized questionnaire. Patients who underwent IIA embolization were compared with matched control patients with blunt pelvic trauma who did not undergo pelvic arteriography. Individuals were matched by age, sex, year of admission, and injury scores.


RESULTS
There were no significant differences in skin necrosis, sloughing, pelvic perineal infection, or nerve injury between embolized and nonembolized patients within 30 days. There was no significant difference in claudication, skin ulceration, or regional pain at a mean of 18.4 months follow-up. In the long term, buttock, thigh, and perineal paresthesia occur at a significantly higher rate in embolized patients. Skin sloughing in the embolized patient group is an important but rare complication.


CONCLUSIONS
IIA embolization is an important means of controlling pelvic arterial hemorrhage. There is no significant increase in the risk of most evaluated long- and short-term complications in trauma patients who underwent IIA embolization versus those who did not. However, IIA embolization is associated with a marginally significantly increased rate of buttock, thigh, or perineal paresthesia.
Travis
Talitha
T
University of California Davis Medical School, University of California Davis Medical Center, 4860 Y Street, Suite 3100, Sacramento, CA 95817, USA.
Monsky
Wayne L
WL
London
Jason
J
Danielson
Matthew
M
Brock
John
J
Wegelin
Jacob
J
Link
Daniel P
DP
D000368:Aged; D000792:Angiography; D016009:Chi-Square Distribution; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007083:Iliac Artery; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000098:blood supply / Q000293:injuries*; D011183:Postoperative Complications / Q000453:epidemiology*; D015641:Radiography, Interventional; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*