Internal Iliac Artery Embolization versus Silastic Loop Ligation for Control of Traumatic Pelvic Hemorrhage
Angioembolization versus open control of traumatic pelvic hemorrhage is debated. We sought to compare outcomes between angioembolization and open internal iliac artery occlusion. A 14-year retrospective review (2004‐2017) was performed at our academic Level I trauma center. All pelvic hemorrhage patients who underwent internal iliac artery angioembolization or silastic loop ligation via laparotomy were compared for outcomes. Patient demographics included vital signs, mechanism, and injury severity score (ISS). Outcomes included mortality (%), operating room visits, reoperation for hemorrhage (%), transfusion burden (units), and infection (%). A total of 163 trauma patients matched for age, ISS, mechanism, and cavitary involvement were included for analysis. Compared with silastic loop ligation (n = 51, mean ISS = 32 ± 14), patients who underwent angioembolization (n = 112, mean ISS = 30 ± 8.9) demonstrated decreased mortality (23% vs 57%, P < 0.01), made fewer operating room trips (mean = 2.2 vs 3.6 trips, P < 0.01), made fewer trips for pelvic (2.8 vs 11%, P = 0.05) and nonpelvic-related bleeding (3.6 vs 22%, P < 0.01), used fewer blood products [packed red blood cells, fresh-frozen plasma, platelets, and cryoprecipitate] (P < 0.01 for all), and indicated a trend toward fewer infections (5.7% vs 14%, P = 0.07). Internal iliac artery angioembolization demonstrates lower mortality, lower reoperation rates, decreased transfusion burden, and a trend toward fewer infections compared with silastic loop ligation.
No Reference information available - sign in for access.
No Citation information available - sign in for access.
No Supplementary Data.
No Article Media
Document Type: Research Article
Publication date: October 1, 2018
More about this publication?
- The Southeastern Surgical Congress owns and publishes The American Surgeon monthly. It is the official journal of the Congress and the Southern California Chapter of the American College of Surgeons, which all members receive each month. The journal brings up to date clinical advances in surgical knowledge in a popular reference format. In addition to publishing papers presented at the annual meetings of the associated organizations, the journal publishes selected unsolicited manuscripts. If you have a manuscript you'd like to see published in The American Surgeon select "Information for Authors" from the Related Information options below. A Copyright Release Form must accompany all manuscripts submitted.
- Information for Authors
- Submit a Paper
- Subscribe to this Title
- Membership Information
- Annual Scientific Meeting
- Ingenta Connect is not responsible for the content or availability of external websites