Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients
Roberto Minici,
Michele Mercurio,
Giuseppe Guzzardi,
Massimo Venturini,
Federico Fontana,
Luca Brunese,
Pasquale Guerriero,
Raffaele Serra,
Filippo Piacentino,
Marco Spinetta,
Lorenzo Zappia,
Davide Costa,
Andrea Coppola,
MGJR Research Team,
Olimpio Galasso,
Domenico Laganà
Affiliations
Roberto Minici
Radiology Unit, Dulbecco University Hospital, 88100 Catanzaro, Italy
Michele Mercurio
Department of Orthopaedic and Trauma Surgery, Magna Græcia University, Dulbecco University Hospital, 88100 Catanzaro, Italy
Giuseppe Guzzardi
Radiology Unit, Maggiore della Carità University Hospital, 28100 Novara, Italy
Massimo Venturini
Diagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, Italy
Federico Fontana
Diagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, Italy
Luca Brunese
Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
Pasquale Guerriero
Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
Raffaele Serra
Vascular Surgery Unit, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Dulbecco University Hospital, 88100 Catanzaro, Italy
Filippo Piacentino
Diagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, Italy
Marco Spinetta
Radiology Unit, Maggiore della Carità University Hospital, 28100 Novara, Italy
Lorenzo Zappia
Radiology Unit, Dulbecco University Hospital, 88100 Catanzaro, Italy
Davide Costa
Department of Law, Economics and Sociology, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy
Andrea Coppola
Diagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, Italy
MGJR Research Team
Magna Graecia Junior Radiologists Research Team, 88100 Catanzaro, Italy
Olimpio Galasso
Department of Orthopaedic and Trauma Surgery, Magna Græcia University, Dulbecco University Hospital, 88100 Catanzaro, Italy
Domenico Laganà
Radiology Unit, Dulbecco University Hospital, 88100 Catanzaro, Italy
Background: Endovascular intervention is now the primary line of therapy for arterial injury brought on by pelvic trauma since it can significantly reduce considerable morbidity associated with surgery and can swiftly access and control bleeding sites. Despite international guidelines and widespread awareness of the role of angioembolization in clinical practice, robust evidence comparing the outcomes of angioembolization in hemodynamically stable and unstable patients is still lacking. This study aims to directly compare the outcomes of angioembolization for the treatment of pelvic traumatic arterial injury in patients with hemodynamic stability vs. hemodynamic instability. Methods: In our multicenter retrospective investigation, we analyzed data from consecutive patients who underwent, from January 2020 to May 2023, angioembolization for traumatic pelvic arterial injury. Results: In total, 116 angioembolizations were performed. Gelatin sponges (56.9%) and coils (25.9%) were the most widely used embolic agents. The technical and clinical success rates were 100% and 91.4%, respectively. No statistically significant differences were observed between the two groups in terms of technical success, clinical success, procedure-related complication rate, or 30-day bleeding-related mortality. Conclusions: Angioembolization is an effective and safe option for the management of traumatic pelvic arterial lesions even in hemodynamically unstable patients, despite technical variations such as greater use of prophylactic angioembolization.
