Hemorrhage remains the leading cause of mortality in patients with severe pelvic fractures. To elucidate efficacy of emergency pelvic angiography and transcatheter arterial embolization, of 228 patients with pelvic fracture from January 1985 to July 1991, we reviewed 64 consecutive patients who underwent pelvic angiography for intractable pelvic hemorrhage. Their ages ranged from 6 to 85 years with an average of 44.7 years.
In these 64 patients, 47 had active bleeding vessels and 53 underwent transcatheter arterial embolization. Of the 45 patients whose systolic blood pressure was less than 100mmHg at the time of their arrival to the emergency room, pelvic angiography was performed in 37 patients within 6 hours of their injuries, and 33 patients underwent arterial embolization. We conclude that pelvic angiography should be performed when pelvic fracture is diagnosed as the primary source of intractable hemorrhage, moreover, transfusion and/or fluid therapy alone is not effective. To manage severe pelvic fracture, cooperation between the departments of surgery, orthopedics and radiology is important.
