• Nghia-Jack Vo, Morgan Althoen, Daniel S Hippe, Somnath J Prabhu, Karim Valji, and Siddharth A Padia.
• Department of Radiology and Section of Pediatric Interventional Radiology and Vascular and Interventional Radiology, Seattle Children's Hospital and the University of Washington, Seattle, Washington. Electronic address: nvo@chw.org.
• J Vasc Interv Radiol. 2014 Feb 1;25(2):215-20.

PurposeAlthough transcatheter embolization is a well established technique to treat adults in the trauma setting, evidence is lacking in the pediatric population. This study assesses the safety and efficacy of arterial embolization for blunt abdominal and pelvic trauma in the pediatric population.Materials And MethodsA retrospective review of abdominal and pelvic angiograms in 97 pediatric patients with blunt trauma was conducted over an 11-year period. Abdominal angiography and embolization was performed for ongoing hepatic, renal, splenic, or nonvisceral retroperitoneal injury. Pelvic angiography was performed in the setting of pelvic fracture with ongoing pelvic hemorrhage. Complications and clinical success rates of these procedures were assessed.ResultsOf the 97 pediatric patients who underwent angiography for acute abdominal or pelvic trauma, 54 (56%) required embolization involving 62 separate sites. Injury severity score greater than 15 was present in 94% of patients. Targets of embolization included the pelvis (n = 39), liver (n = 8), kidney (n = 7), spleen (n = 6), and retroperitoneum (n = 2). Effective hemorrhage control was achieved in 47 patients (87%). Overall mortality rate was 22% (12 of 54), with most deaths related to traumatic brain injury. Five complications occurred in four patients (7%), including three major complications (hepatic abscess, bile leak, and urinary incontinence).ConclusionsAngiography and embolization is relatively safe and potentially effective in the setting of abdominal and pelvic trauma in the pediatric population. Angiography with embolization should be considered in the treatment algorithm for this patient population.© 2014 The Society of Interventional Radiology Published by SIR All rights reserved.

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