title: Complications after transcatheter arterial embolization for pelvic trauma: relationship to level and laterality of embolization.
abstract: OBJECTIVE
  Transcatheter arterial embolization (TAE) is commonly used to control hemorrhage after pelvic trauma. Despite the procedures reported safety, there can be severe complications, mostly related to ischemia of embolized tissues. Our purpose was to examine the complications of trauma patients resulting from the embolization techniques utilized at our level 1 trauma center.
  
  
  METHODS
  A retrospective chart review was conducted. One hundred and seven patients who underwent pelvic embolization between January 2003 and December 2013 were included. Patient demographics, ISS, angiography techniques, and major complications including gluteal and skin necrosis, wound breakdown, and deep infection were compared.
  
  
  RESULTS
  Nine patients (8.4 %) developed major complications after undergoing TAE. This rate dropped to 5.1 % after exclusion of patients with Morel-Lavallee lesions. Nonselective embolization trended toward a higher complication rate compared to superselective embolization. Patients who developed complications were more likely to have undergone pelvic surgery.
  
  
  CONCLUSIONS
  The majority of patients who developed complications had nonselective TAE. Morel-Lavallee lesions are a confounding factor, but TAE may impose an additional risk. Pelvic surgery after TAE may further predispose patients to complications. We recommend superselective embolization as first-line treatment and caution the use of prophylactic embolization, especially in patients with substantial pelvic soft tissue injuries.
authors.affiliation: Department of Radiology, UCLA Medical Center, Los Angeles, USA.
authors.forename: James
authors.initials: J
authors.lastname: Shi
authors.affiliation: Department of Interventional Radiology, UCLA Medical Center, 757 Westwood Ave., Suite 2125C, Los Angeles, CA, 90095, USA.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Gomes
authors.affiliation: Department of Interventional Radiology, UCLA Medical Center, 757 Westwood Ave., Suite 2125C, Los Angeles, CA, 90095, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Lee
authors.affiliation: Department of Interventional Radiology, UCLA Medical Center, 757 Westwood Ave., Suite 2125C, Los Angeles, CA, 90095, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Kee
authors.affiliation: Department of Interventional Radiology, UCLA Medical Center, 757 Westwood Ave., Suite 2125C, Los Angeles, CA, 90095, USA.
authors.forename: John
authors.initials: J
authors.lastname: Moriarty
authors.affiliation: Department of Surgery, UCLA Medical Center, Los Angeles, USA.
authors.forename: Henry
authors.initials: H
authors.lastname: Cryer
authors.affiliation: Department of Interventional Radiology, UCLA Medical Center, 757 Westwood Ave., Suite 2125C, Los Angeles, CA, 90095, USA. jumcwilliams@mednet.ucla.edu.
authors.forename: Justin
authors.initials: J
authors.lastname: McWilliams
mesh_terms: D000328:Adult; D000792:Angiography / Q000379:methods; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000098:blood supply / Q000293:injuries; D012189:Retrospective Studies; D014481:United States; D057772:Vascular System Injuries / Q000209:etiology / Q000628:therapy
keywords: Embolization; Pelvic; Trauma