Nihon Igaku Hoshasen Gakkai zasshi. Nippon acta radiologica · 2004
[Clinical evaluation of transcatheter arterial embolization for the management of retroperitoneal bleeding in cases of pelvic fracture].
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Sugahara Takeshi, Saito Ryuichi, Murakami Ryuji, Miyazaki Toshiyuki
Аннотация
PURPOSE: We evaluated the clinical efficacy of TAE for the management of retroperitoneal bleeding in a case of pelvic fracture.
MATERIALS AND METHODS: A retrospective review of 206 patients with pelvic fractures was performed. Thirty-four patients who were hemodynamically unstable or had evidence of ongoing hemorrhage required TAE. Rescue rate, effective rate, and mortality rate among the patients with multiple organ injuries were calculated. Charts were reviewed for age, Japanese coma scale (JCS), hemoglobin, blood pressures, extent of retroperitoneal hemorrhage, pelvic fracture pattern/extent of embolization, and time from judging indication of TAE to angiography. Data of patients who died of pelvic fracture hemorrhage was compared with that of others. Statistical analysis was done with analysis of variance, and the two groups were compared using Student's t-test.
RESULTS: Rescue rate, success rate, and mortality rate were 76% (26/34), 91% (31/34), and 33% (8/24), respectively. Only JCS reached statistical significance. The complications of gluteal skin and muscle necrosis were experienced in one patient. Two patients with lung contusion and one patient who had suffered from idiopathic interstitial pneumonia died from disseminated intravascular coagulation associated with pneumonia. Viscorectal dysfunctions, which were observed in ten patients, were considered to be independent of TAE.
CONCLUSION: TAE for pelvic fracture hemorrhage was considered effective. Complications of gluteal skin and muscle necrosis should be kept in mind.
MATERIALS AND METHODS: A retrospective review of 206 patients with pelvic fractures was performed. Thirty-four patients who were hemodynamically unstable or had evidence of ongoing hemorrhage required TAE. Rescue rate, effective rate, and mortality rate among the patients with multiple organ injuries were calculated. Charts were reviewed for age, Japanese coma scale (JCS), hemoglobin, blood pressures, extent of retroperitoneal hemorrhage, pelvic fracture pattern/extent of embolization, and time from judging indication of TAE to angiography. Data of patients who died of pelvic fracture hemorrhage was compared with that of others. Statistical analysis was done with analysis of variance, and the two groups were compared using Student's t-test.
RESULTS: Rescue rate, success rate, and mortality rate were 76% (26/34), 91% (31/34), and 33% (8/24), respectively. Only JCS reached statistical significance. The complications of gluteal skin and muscle necrosis were experienced in one patient. Two patients with lung contusion and one patient who had suffered from idiopathic interstitial pneumonia died from disseminated intravascular coagulation associated with pneumonia. Viscorectal dysfunctions, which were observed in ten patients, were considered to be independent of TAE.
CONCLUSION: TAE for pelvic fracture hemorrhage was considered effective. Complications of gluteal skin and muscle necrosis should be kept in mind.