To evaluate the role of endovascular treatment in controlling active bleeding, false aneurysms or vessel occlusions in polytrauma patients with pelvic vascular injuries with or without associated pelvic fractures.

From March 2009 to April 2010, 36 patients (25 men - 11 women) with major pelvic trauma associated with high-flow hemorrhage were referred to our emergency department. All patients underwent CT examination. Vascular injuries were in 11 cases of superior gluteal artery, 5 of lateral sacral artery, 7 of internal pudendal artery, 2 of lumbar artery, 4 of common femoral artery, 1 of external iliac artery, 1 of inferior gluteal artery, 2 of obturator artery and 3 cases of the hypogastric artery. In 34 cases...

The technical success rate was 100% documented at post-procedural angiography; no complications occurred during the procedures. Clinical efficacy was 100%; in fact, none of the patients had to undergo a new arteriography for hemorrhage recurrence. From all, 34 patients had a stabilization of vital parameters. Two patients died.

In our study, percutaneous control of pelvic hemorrhages showed a valuable therapeutic option: transarterial embolization is a rapid, safe, effective and minimally invasive technique, features that make it very useful in this setting, where the clinical course and prognosis are related to the achievement of hemodynamic stability.

1. Gansslen A, Giannoudis P, Pape HC. (2003) Hemorrhage in pelvic fracture: who needs angiography? Curr Opin Crit Care; 9: 515-523 2. Heetveld MJ, Harris I, Schlaphoff G, et al. (2004) Guidelines for the management of haemodynamically unstable pelvic fracture patients. ANZ J. Surg; 74: 520-529. 3. Dondelinger RF, Trotteur G, Ghaye B, et al. (2002) Traumatic injures: radiological hemostatic intervention at admission. Eur. Radiol.; 12: 979-993. 4. Blackmore CC, Cummings P, Jurkovich GJ, Linnau KF, Hoffer EK, Rivara FP. Predicting major hemorrhage in patients...