Abstract No. 460 Absence of gluteal necrosis following pelvic embolization in trauma patients

Abstract

This study evaluates the incidence of gluteal necrosis following Gelfoam and coil embolization in the setting of acute trauma at a single institution. Pelvic trauma patients requiring urgent pelvic embolization at a single institution from September 2018 to September 2020 were retrospectively analyzed. Data were collected from EMR and PACS systems. Embolization was performed using Gelfoam slurry, coils, or a combination of both. Location of embolization was recorded. CT scans were reviewed prior to embolization for presence of gluteal abnormalities. Gluteal pain, weakness, and neuropathy were monitored up to 2 weeks post-procedure. Available CT scans were reviewed 2 weeks post-operatively for signs of gluteal necrosis. 7 patients (mean age, 66.1 years; 4 men) underwent urgent nonselective pelvic embolization of the anterior and posterior divisions bilaterally in the setting of pelvic trauma. Of these patients, 4/7 underwent embolization with Gelfoam slurry, 1/7 with coil embolization, and 2/7 with a combination. 4/7 of these patients underwent subsequent orthopedic pelvic surgery without complication; 3/7 patients did not have subsequent surgery. 0/7 of these patients exhibited any signs of gluteal necrosis on CT on 2-week follow up. In regard to symptomatic follow up, 1 patient exhibited pedal neuropathy on the side contralateral to embolization and 1 patient exhibited lower extremity weakness at 5 months which was presumed to be a result surgical deconditioning. No gluteal pain or dysfunction was identified clinically for any patient. In this small cohort, nonselective pelvic embolization in trauma patients is safe without gluteal symptoms post-procedurally and without deleterious effects on subsequent orthopedic surgery