• Rahul Vaidya, Jacob Waldron, Alesha Scott, and Kerellos Nasr.
• From the Department of Orthopaedic Surgery, Detroit Receiving Hospital, Detroit Medical Center, Detroit, MI (Dr. Vaidya), the Department of Orthopaedic Surgery, Michigan State University, Detroit Medical Center, Detroit (Dr. Waldron), the Department of Orthopaedic Surgery, Michigan State University, McLaren Oakland Hospital, Pontiac, MI (Dr. Scott), and the Department of Orthopaedic Surgery, Wayne State University, Detroit Medical Center, Detroit (Dr. Nasr).
• J Am Acad Orthop Surg. 2018 Feb 15; 26 (4): e68-e76.

AbstractThe use, timing, and priority of angioembolization in the management of bleeding pelvic fractures remain ambiguous. The most common vessels for angioembolization are, in decreasing order, the internal iliac artery and its branches, the superior gluteal artery, the obturator artery, and the internal pudendal artery. Technical success rates for this treatment option range from 74% to 100%. The fracture patterns most commonly requiring angioembolization are the Young and Burgess lateral compression and anterior-posterior compression types and Tile type C. Mortality rates after angioembolization of 16% to 50% have been reported, but deaths are usually related to concomitant injuries. The sensitivity and specificity of contrast-enhanced CT in detecting the need for angioembolization range from 60% to 90% and 92% to 100%, respectively. Angioembolization can be effective in the management of bleeding pelvic fractures, but as with any treatment, the risks of complications must be considered. Availability of angioembolization and institutional expertise/preference for the alternative strategy of pelvic packing influence its use.

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