Bilateral Internal Iliac Artery Embolization Results in an Unacceptably High Rate of Complications in Patients Requiring Pelvic/Acetabular Surgery.

Abstract

To assess complication rates in patients undergoing open reduction internal fixation (ORIF) of pelvic/acetabular fractures with and without pelvic angiography embolization (PAE). Retrospective case series. Level 1 Trauma Center. One hundred eleven patients with pelvic or acetabular fractures that required orthopaedic fixation. Retrospective analysis of outcomes in patients who underwent ORIF of pelvic/acetabular fractures with and without PAE. Comparison of surgical wound infections, necrosis, and/or fracture nonunions between the PAE group and a control group (no PAE). Final study groups consisted of 50 patients in the PAE group and 61 patients in the control group. Ninety-six percent of patients underwent nonselective PAE. Significantly higher complications were noted in the PAE group than in the control group (20% compared with 4.9%; P = 0.020). In addition, posterior surgical approaches combined with internal iliac artery embolization represented the highest complication rate. Patients requiring PAE and pelvic/acetabular ORIF should undergo a multidisciplinary treatment approach with the trauma surgeon, interventional radiologist, and orthopaedic surgeon before PAE being performed to decrease complications and avoid nonselective bilateral internal iliac artery embolization. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.