Travis Talitha, Monsky Wayne L, London Jason, Danielson Matthew, Brock John, Wegelin Jacob, Link Daniel P
University of California Davis Medical School, University of California Davis Medical Center, 4860 Y Street, Suite 3100, Sacramento, CA 95817, USA.
J Vasc Interv Radiol. 2008 Jun;19(6):840-7. doi: 10.1016/j.jvir.2008.02.011. Epub 2008 Apr 10.
To assess the incidence of long- and short-term complications following internal iliac artery (IIA) embolization after blunt pelvic trauma.
One hundred trauma patients with pelvic fractures underwent pelvic angiography from 1994 through 2006. Sixty-seven patients underwent IIA embolization. These patients were retrospectively identified for medical record review. Short- and long-term complications were defined as those occurring at less than or greater than 30 days, respectively. Complications and outcomes were assessed through chart review and, when possible, a standardized questionnaire. Patients who underwent IIA embolization were compared with matched control patients with blunt pelvic trauma who did not undergo pelvic arteriography. Individuals were matched by age, sex, year of admission, and injury scores.
There were no significant differences in skin necrosis, sloughing, pelvic perineal infection, or nerve injury between embolized and nonembolized patients within 30 days. There was no significant difference in claudication, skin ulceration, or regional pain at a mean of 18.4 months follow-up. In the long term, buttock, thigh, and perineal paresthesia occur at a significantly higher rate in embolized patients. Skin sloughing in the embolized patient group is an important but rare complication.
IIA embolization is an important means of controlling pelvic arterial hemorrhage. There is no significant increase in the risk of most evaluated long- and short-term complications in trauma patients who underwent IIA embolization versus those who did not. However, IIA embolization is associated with a marginally significantly increased rate of buttock, thigh, or perineal paresthesia.
评估钝性骨盆创伤后髂内动脉（IIA）栓塞术的近期和远期并发症发生率。
1994年至2006年期间，100例骨盆骨折的创伤患者接受了骨盆血管造影。其中67例患者接受了IIA栓塞术。对这些患者进行回顾性病历审查。近期和远期并发症分别定义为发生在30天以内或超过30天的并发症。通过病历审查并在可能的情况下通过标准化问卷评估并发症和预后。将接受IIA栓塞术的患者与未进行骨盆动脉造影的钝性骨盆创伤对照患者进行比较。根据年龄、性别、入院年份和损伤评分进行个体匹配。
栓塞组和未栓塞组患者在30天内皮肤坏死、脱落、盆腔会阴感染或神经损伤方面无显著差异。在平均18.4个月的随访中，跛行、皮肤溃疡或局部疼痛方面无显著差异。从长期来看，栓塞患者臀部、大腿和会阴感觉异常的发生率显著更高。栓塞患者组的皮肤脱落是一种重要但罕见的并发症。
IIA栓塞术是控制骨盆动脉出血的重要手段。与未接受IIA栓塞术的创伤患者相比，接受该手术的患者大多数评估的近期和远期并发症风险没有显著增加。然而，IIA栓塞术与臀部、大腿或会阴感觉异常发生率的轻微显著增加有关。
