Department of Traumatology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, 1 Jiankang Road, 400014, Yuzhong District, Chongqing, China.
BMC Musculoskelet Disord. 2021 Apr 14;22(1):355. doi: 10.1186/s12891-021-04212-w.
A recently published article by Lai et al. in BMC Musculoskeletal Disorders trying to show that patients with pelvic fractures undergoing non-selective internal iliac artery embolization may lead to a higher rate of surgical site infection. The authors also noted that only a small percentage of patients with contrast extravasation detected by emergency contrast-enhanced CT were subsequently confirmed by angiography, thus, considered that the value of enhanced CT in predicting arterial injury was limited. The authors also believe that embolization of the main stem may cause incomplete hemostasis due to the abundant collateral circulations in the pelvic cavity. Although the author's findings are mentioned in other studies, the article's data and pictures only partially supported its inferences, and the conclusions cannot be drawn directly. In this Correspondence, we tried to reinterpret the additional findings in the article from our perspective. Through this discussion, we hope that more colleagues can re-understand the safety and effectiveness of non-selective internal iliac artery embolization in treating hemodynamically unstable pelvic fractures during the early resuscitation stage.
最近，赖等人在《BMC 肌肉骨骼疾病》上发表了一篇文章，试图表明接受非选择性髂内动脉栓塞治疗的骨盆骨折患者可能会导致更高的手术部位感染率。作者还指出，只有一小部分在急诊增强 CT 检查中发现造影剂外渗的患者随后通过血管造影得到证实，因此，认为增强 CT 在预测动脉损伤方面的价值有限。作者还认为，由于盆腔内丰富的侧支循环，主干栓塞可能导致不完全止血。尽管其他研究也提到了作者的发现，但文章的数据和图片仅部分支持其推论，不能直接得出结论。在这篇通信中，我们试图从我们的角度重新解释文章中的其他发现。通过这次讨论，我们希望更多的同事能够重新理解在早期复苏阶段治疗血流动力学不稳定骨盆骨折时，非选择性髂内动脉栓塞治疗的安全性和有效性。
