• Andrew D Auerbach, Saqib Rehman, and Matthew T Kleiner.
• Department of Orthopaedic Surgery, Temple University Hospital, Philadelphia, PA 19140, USA.
• J Orthop Trauma. 2012 May 1;26(5):290-5.

ObjectivesThe aim of this study is to determine if selective transcatheter arterial embolization (TAE) of the branches of the internal iliac artery in patients with pelvic trauma is a risk for gluteal necrosis.DesignRetrospective chart review.SettingCivilian Level I trauma center.PatientsTwenty patients with pelvic fractures and hemorrhage.InterventionSelective and nonselective TAE of the internal iliac artery and its branches.Main Outcome MeasurementThe location of all fractures was identified as well as the fracture type. Selective TAE was also distinguished from nonselective TAE. Orthopaedic surgical intervention was recorded. Cases of gluteal necrosis and wound infection were recorded as well as renal failure and anaphylactic reaction to intravenous contrast.ResultsOf the 551 patients identified with pelvic fractures, 20 patients were identified to have undergone TAE from January 2004 to January 2009. Of these, 18 cases were treated with selective TAE and two with nonselective unilateral TAE. No complications of gluteal muscle or pelvic skin necrosis, wound infection, renal failure, or anaphylaxis were noted in any of these cases. Average patient age was 55 years with average Injury Severity Score 17. Eleven cases underwent orthopaedic surgical procedures, eight of which involved open reduction and internal fixation of the acetabulum or hemiarthroplasty of the hip.ConclusionsSelective TAE of internal iliac branches including the gluteal arterial branches appears to be safe in patients with pelvic and acetabular fractures with and without orthopaedic surgical treatment. Nonselective TAE of the internal iliac artery may also be safe when performed unilaterally.Level Of EvidenceTherapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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