Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
권호 표지

Treatment Strategy of Transcatheter Arterial Embolization after Pelvic CT Angiography in Traumatic Pelvic Hemorrhage : A Single Regional Emergency Center's Experience

외상성 골반 출혈환자에서 CT 혈관조영술 후 동맥 색전술을 시행하는 치료방침의 유용성: 단일 권역응급센터의 경험

  • Lee, Yu Jin (Department of Emergency Medicine, Seoul National University Hospital) ;
  • Jae, Hwan Jun (Department of Emergency Medicine, Seoul National University Hospital) ;
  • Cha, Won Chul (Department of Emergency Medicine, Seoul National University Hospital) ;
  • Seo, Jun Seok (Department of Emergency Medicine, Seoul National University Hospital) ;
  • Kim, Hyo Cheol (Dpartment of Radiology, Seoul National University Hospital) ;
  • Shin, Cheong-Il (Dpartment of Radiology, Seoul National University Hospital) ;
  • Shin, Sang Do (Department of Emergency Medicine, Seoul National University Hospital)
  • 이유진 (서울대학교병원 응급의학과) ;
  • 제환준 (서울대학교병원 응급의학과) ;
  • 차원철 (서울대학교병원 응급의학과) ;
  • 서준석 (서울대학교병원 응급의학과) ;
  • 김효철 (서울대학교병원 영상의학과) ;
  • 신청일 (서울대학교병원 영상의학과) ;
  • 신상도 (서울대학교병원 응급의학과)
  • Received : 2009.08.07
  • Accepted : 2009.09.25
  • Published : 2009.12.30
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Abstract

Purpose: This study was conducted to evaluate the effectiveness of the treatment strategy of transcatheter arterial embolization after pelvic CT angiography (CTA) in cases of traumatic pelvic hemorrhage. Methods: This is a retrospective analysis of pelvic hemorrhage patients who underwent transcatheter arterial embolization after pelvic CTA at our regional emergency center during a 31-month period. We reviewed the medical records and imagings of all these patients. Results: Transcatheter arterial embolization was performed in 17 patients (M:F=7:10, mean age=53.9) who underwent pelvic CTA for the evaluation of traumatic pelvic hemorrhage. Arterial bleeding was demonstrated on pelvic CTA in all patients, and the combined injury was also noted in 13 patients. The admission-to-CTA time was $84.53{\pm}66.92$ minutes, and the CTA-to-embolization time was $147.65{\pm}99.97$ minutes. Extravasation of contrast media or pseudoaneurysm was demonstrated on conventional angiography in all patients. Unilateral iliac artery embolization was performed in 8 patients, and bilateral iliac artery embolization was performed in 9 patients. Additional embolizations other than in the iliac arteries were performed in 7 patients. Initial hemostasis was achieved in 16 patients. One patient died of ongoing pelvic bleeding. Rebleeding occurred in only one patient and hemostasis was achieved with the second embolization. Another patient died of intracranial and facial bleeding in spite of pelvic hemostasis. The overall mortality was 11.8%, and there was no significant adverse effects in the other patients. Conclusion: Transcatheter arterial embolization after pelvic CTA is an effective treatment strategy in the management of traumatic pelvic hemorrhage patients.

Keywords

References

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