• Todd W Costantini, Patrick L Bosarge, Dale Fortlage, Vishal Bansal, and Raul Coimbra.
• Division of Trauma, Surgical Critical Care, and Burns, Department of Surgery, University of California, San Diego School of Medicine, San Diego, CA 92103-8896, USA.
• Am. J. Surg. 2010 Dec 1;200(6):752-7; discussion 757-8.

BackgroundWe hypothesized that arterial embolization for bleeding after pelvic fracture is used relatively infrequently. We sought to identify the true need for arterial embolization and define injury patterns associated with successful therapeutic angiographic embolization.MethodsA retrospective review identified patients admitted to our urban, Level 1 trauma center with pelvic fractures from 2001 to 2009. Patients requiring pelvic arterial angiogram and embolization of pelvic bleeding were reviewed for pelvic fracture pattern and pelvic injury mechanism.ResultsThere were 819 patients diagnosed with pelvic fractures, with only 31 patients (3.8%) undergoing diagnostic pelvic angiography. Of those, 18 patients (58.1%) had active bleeding requiring arterial embolization. Complex pelvic fracture patterns were common in patients undergoing angiogram. Patients undergoing pelvic angiography with an anteroposterior compression mechanism were more likely to have negative findings on angiogram.ConclusionsThe actual need for angiography and therapeutic embolization is quite small in patients sustaining pelvic fracture. Although factors associated with the need for pelvic angiography frequently are debated, we may discuss angiography for pelvic fractures more often than it actually is performed.Copyright © 2010 Elsevier Inc. All rights reserved.

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