Treatment of pelvic fracture and hemorrhagic shock by emergency interventional arterial embolization combined with percutaneous minimally invasive screw internal fixation: Report of 21 cases / 中国介入影像与治疗学

ABSTRACT

Objective To explore the feasibility and safety of emergency interventional arterial embolization combined with percutaneous minimally invasive screw fixation in the treatment of pelvic fracture combined with hemorrhagic shock.Methods A retrospective analysis of 21 patients with pelvic fractures and hemorrhagic shock who were treated with emergency interventional arterial embolization combined with percutaneous minimally invasive screw fixation was performed.The percutaneous minimally invasive screw fixation was performed immediately after embolization.Results There were 18 of 21 cases with obvious arterial bleeding confirmed by femoral artery angiography.And the corresponding interventional embolization was performed.No obvious arterial hemorrhage was found in the other 3 cases who received suspicious hemorrhagic internal iliac arterial prophylactic embolization.The time-consuming of percutaneous minimally invasive screw fixation was no more than 90 min for each patient.There was no servious complication associated with arterial embolization after intervention.Totall 18 cases were improved after discharge.Another 3 cases died,including 2 cases died for postoperative multiple organ failure or disseminated intravascular coagulation,1 case died for hemorrhagic shock caused by still continue bleeding after surgery.The postoperative follow-up was performed during 3-18 months with the average of (10.81 ± 2.62) months.The fractures in all the surviving cases achieved bone healing with good function.Conclusion The emergency interventional arterial embolization combined with percutaneous minimally invasive screw fixation is a safe,fast and effective method for the treatment of pelvic fractures and hemorrhagic shock with less complications.