Abstract No. 293 - A retrospective review of the impact of CT on angiographic embolization procedures in pelvic trauma patients

Abstract

Purpose In pelvic trauma patients, arterial embolization is often a life saving procedure. We sought to study if performing a CT prior to angiography with embolization impacts on the fluoroscopic time (FT), radiation dose (RD) and contrast dose (CD). Clinical outcomes were number of blood transfusions and mortality. Materials and Methods A retrospective review of 54 pelvic trauma angiographies performed at the McGill University Health Centre (MUHC) level 1 trauma centre, Montreal, Canada, was performed. FT, RD and CD were obtained from the Radiology Information System and angiography logbooks. Mortality, number of transfusions and Injury Severity scores (ISS) were obtained from a prospectively collected database. ISS was used as a measure of trauma severity. The institutional ethics committee approved the study. Results Age and sex were similar in both groups. RD was lower in the group that had a CT prior to angiography (1360 vs 3378 mGy; p Mortality was lower in the group that had a CT prior to angiography (7.5% vs 64.3%; p Conclusion In our cohort of pelvic trauma patients who underwent angiography and embolization, performing a pre-procedure CT led to a reduction in FT, RD and CD, which may due to a more directed procedure. We also found a significantly lower mortality in the group that had a CT prior to angiography. Although the trauma severity score was not different between the groups, we cannot exclude that this group had less severe injuries, as they also received less blood transfusions. In order to better assess the reason for these differences, other confounding factors that will be discussed include the number of selective versus non selective embolizations, concurrent procedures performed (e.g., IVC filter insertion), cause of death, time to angiography, and prevalence of concurrent injuries.