Interventional vascular, Pelvis, Vascular, Catheter arteriography, CT, Ultrasound-Colour Doppler, Arterial access, Catheters, Embolisation, Blood, Haemorrhage
S. Cayón Somacarrera, M. C. Iniesta González, M. L. Parra Gordo, A. Mingo Basail, I. Galán González
Vascular pelvic injuries are the major cause of morbidity and mortality in blunt trauma patients. Historically they have been evaluated with arteriography. However, the development of CT allows us to perform a rapid non-invasive evaluation, helping us to differentiate between arterial and venous bleeding which is a key factor when considering the most suitable treatment.
Once we have identified there is an arterial active bleeding and we have determined its location, knowing the zonal pelvic vascularization map can help us determine the most probable bleeding artery so that the interventional radiologist can perform a more selective arteriography.
These findings have generally been seen to correlate with findings later found in arteriography. However, it has been seen that in 20-40% of patients who did not show active arterial bleeding on CT, had it on arteriography. This could be due to intermittent bleeding secondary to arterial spasm or temporary tamponade by the hematoma itself.