Bilateral Internal Iliac Artery Embolization Results in an Unacceptably High Rate of Complications in Patients Requiring Pelvic/Acetabular Surgery
Abstract
OBJECTIVES: To assess complication rates in patients undergoing open reduction internal fixation (ORIF) of pelvic/acetabular fractures with and without pelvic angiography embolization (PAE).
DESIGN: Retrospective case series.
SETTING: Level 1 Trauma Center.
PATIENTS/PARTICIPANTS: One hundred eleven patients with pelvic or acetabular fractures that required orthopaedic fixation.
INTERVENTION: Retrospective analysis of outcomes in patients who underwent ORIF of pelvic/acetabular fractures with and without PAE.
MAIN OUTCOME MEASUREMENTS: Comparison of surgical wound infections, necrosis, and/or fracture nonunions between the PAE group and a control group (no PAE).
RESULTS: Final study groups consisted of 50 patients in the PAE group and 61 patients in the control group. Ninety-six percent of patients underwent nonselective PAE. Significantly higher complications were noted in the PAE group than in the control group (20% compared with 4.9%; P = 0.020). In addition, posterior surgical approaches combined with internal iliac artery embolization represented the highest complication rate.
CONCLUSIONS: Patients requiring PAE and pelvic/acetabular ORIF should undergo a multidisciplinary treatment approach with the trauma surgeon, interventional radiologist, and orthopaedic surgeon before PAE being performed to decrease complications and avoid nonselective bilateral internal iliac artery embolization.
LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 61 participants or records.
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