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Complications After Pelvic Arteriography in Patients With Pelvic Ring Disruptions

Wiley, Marcel, MD; Black, Sheena, MD; Martin, Case, MD; Barnwell, Jonathan, MD; Starr, Adam, MD; Sathy, Ashoke, MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: November 1, 2018 - Volume 26 - Issue 21 - p 765–772
doi: 10.5435/JAAOS-D-17-00198
Research Article

Introduction: Pelvic angiography with transcatheter arterial embolization (TAE) is an established intervention for management of pelvic arterial hemorrhage. This study analyzes complication rates after angiography among patients with pelvic trauma treated in the context of a multidisciplinary institutional pelvic fracture protocol.

Methods: Retrospective analysis of prospectively collected data was conducted. Demographics, fracture type, embolization (ie, unilateral versus bilateral and selective versus nonselective), and complications (ie, pseudoaneurysm, renal failure, soft-tissue necrosis/infection, and anaphylactic reactions) were noted.

Results: Eighty-one patients with pelvic ring injuries underwent angiography from 2009 to 2013. Complications among 41 patients who underwent angiography with TAE were compared with a control group of 40 patients who underwent angiography without TAE. Eight of 41 patients with TAE had complications (19.5%) compared with 3 of 40 (7.5%) in the control group (P = 0.19). The overall complication rate was 13.6%.

Conclusion: The use of angiography with TAE as part of an institutional pelvic fracture protocol involves an acceptable rate of complications.

Level of Evidence: III

From the Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center at Dallas, Dallas, TX.

Correspondence to Dr. Sathy: Ashoke.sathy@utsouthwestern.edu

Dr. Starr or an immediate family member has received royalties from Starr Frame. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Wiley, Dr. Black, Dr. Martin, Dr. Barnwell, and Dr. Sathy.

© 2018 by American Academy of Orthopaedic Surgeons
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