Armbruster Marco, Seidensticker Max
Klinik und Poliklinik für Radiologie, Klinikum der Universität München, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland.
Unfallchirurg. 2021 Aug;124(8):627-634. doi: 10.1007/s00113-021-01045-z. Epub 2021 Jul 20.
Pelvic arterial bleeding constitutes a potentially life-threatening event, which can be difficult to control with surgical procedures alone, especially in the case of ligamentous ruptures and a subsequently increased pelvic volume.
Using angiography and embolization (AE) with resorbable gelatine-based particles or permanent coils, plugs, liquid embolic systems or by vascular stenting, in most cases traumatic pelvic arterial bleeding can be stopped and can also be used to close pseudoaneurysms, arteriovenous fistulas or dissections.
The AE has become established as a fast and effective minimally invasive procedure in the treatment of traumatic pelvic vascular injuries with an advantageous risk-benefit ratio.
An interdisciplinary approach should be used in the indications for AE; which can be used as definitive treatment as well as in combination with surgical procedures. To improve the clinical outcome any delay between establishing the indications and the start of the intervention must be avoided.
盆腔动脉出血是一种潜在的危及生命的事件，仅通过外科手术可能难以控制，尤其是在韧带断裂且盆腔容积随后增大的情况下。
使用血管造影和栓塞术（AE），采用可吸收的明胶基颗粒、永久性线圈、栓塞栓子、液体栓塞系统或通过血管支架置入，在大多数情况下，创伤性盆腔动脉出血能够得以止血，还可用于闭合假性动脉瘤、动静脉瘘或动脉夹层。
血管造影和栓塞术已成为治疗创伤性盆腔血管损伤的一种快速有效的微创手术，具有有利的风险效益比。
血管造影和栓塞术的适应证应采用多学科方法；该方法既可用作确定性治疗，也可与外科手术联合使用。为改善临床结局，必须避免在确定适应证与开始干预之间出现任何延误。
