Blush on Computed Tomography and Transcatheter Arterial Embolization in Pelvic Fracture

Gwak, Jihun; Yoon, Yong-Cheol; Lee, Min A; Yu, Byungchul; Jang, Myung Jin; Choi, Kang Kook

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자료유형: 학술저널

저자정보: Gwak, Jihun (Department of Trauma Surgery, Gachon University, Gil Medical Center) Yoon, Yong-Cheol (Department of Trauma Surgery, Gachon University, Gil Medical Center) Lee, Min A (Department of Trauma Surgery, Gachon University, Gil Medical Center) Yu, Byungchul (Department of Trauma Surgery, Gachon University, Gil Medical Center) Jang, Myung Jin (Department of Trauma Surgery, Gachon University, Gil Medical Center) Choi, Kang Kook (Department of Trauma Surgery, Gachon University, Gil Medical Center)

저널정보: 대한외상학회 Journal of trauma and injury : JTI Journal of trauma and injury : JTI 제29권 제4호

발행연도: 2016.1

수록면: 161 - 166 (6page)

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Purpose: Bleeding is the primary cause of death after severe pelvic fracture. Transcatheter arterial embolization (TAE) is the mainstay of treatment for arterial bleeding. This study aimed to determine the frequency of bleeding by angiography of blush-positive pelvic fractures on computed tomography (CT) images. The bleeding arteries that were involved were investigated by pelvic angiography. Methods: This retrospective cohort study evaluated 83 pelvic fracture patients who were treated in the intensive care unit of the author's trauma center between January 01, 2013 and April 30, 2015. Results: Overall mortality was 9 of 83 patients (10.8%). Blush was observed in 37 patients; blush-positive patients had significantly higher mortality (24.3%) than blush-negative patients (0%). Twenty-four of the 83 patients (28.9%) underwent pelvic angiography. Bleeding was showed in 22 of 24 patients in pelvic angiography. TAE was successfully performed in 21 (95.5%) of the bleeding 22 patients. Angiography was performed in 23 of 37 blush-positive patients, and arterial bleeding was identified in 21 (91.3%). A total 33 bleeding arteries were identified in 22 angiography-positive patients. The most frequent origin of bleeding was internal iliac artery (69.7%) followed by the external iliac artery (18.2%) and lumbar arteries (12.1%). Conclusion: The vascular blush observed in CT scans indicates sites of ongoing bleeding in pelvic angiography. TAE is an excellent therapeutic option for arterial bleeding and has a high success rate with few complications.

#Pelvic bones #Fractures #Bone #Hemorrhage #Embolization #Therapeutic

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