Recurrent and selective angiographic embolization for patients with haemodynamically unstable pelvic fracture

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Objective To evaluate the effect of selective angiography and embolization for the pa-tients with haemodynamically unstable pelvic fracture. Methods Sixty-two patients with haemodynami-cally unstable pelvic fracture were treated in our hospital from 2002 to 2008. Their pelvie fractures were classified on the basis of their X-ray and CT data. By AO classification, there were 2 cases of type A2, 6 B1, 9 B2, 8 B3, 16 C1, 13 C2, and 8 C. There were 6 cases of open injury (by Gustilo classification, 1 type Ⅱ and 5 type Ⅲ). Of the 46 eases of multiple injuries, 12 had shock. While active fluid infusion and vascular medication were conducted, the angiograph was done for all patients, 59 of whom also received embolization. Results Seventy-nine angiographs were performed for the 62 cases, and 12 of them received more than twice angiographa. Exams revealed that 32 patients had suffered injury to more than 2 arteries. The injured arteries were sequentially superior gluteal artery, iliolumbar artery, lateral sacra] artery, obturator artery, inferior gluteal artery, internal pudendal artery, internal iliae artery and external lilac artery. Of the 59 cases of embolization, 56 were successful. Seven patients died due to severe abdominal organ injury. Forty-five patients got an average follow-up of 14 months (range, 6 to 52 months) . No severe complications were no-ticed. Conclusions Selective angiography and embolization is an effective intervention for patients with haemodynamically unstable pelvic fracture. It is mandatory to conduct recurrent angiographic embolization for patients with multiple artery injuries or delayed artery injuries. Key words: Pelvis; Angiography; Embolization, therapeutic