Kim Yook, Lim Eic Ju
Department of Radiology, Chungbuk National University Hospital, Chugbuk National University College of Medicine, Cheongju, Republic of Korea.
Department of Orthopaedic Surgery, Chungbuk National University Hospital, Chugbuk National University College of Medicine, Cheongju, Republic of Korea.
Medicine (Baltimore). 2025 May 23;104(21):e42491. doi: 10.1097/MD.0000000000042491.
This study aims to assess the safety and efficacy of transcatheter arterial embolization (TAE) of the corona mortis in the aberrant obturator artery (AOA) for the management of bleeding in blunt pelvic trauma. This retrospective analysis included data on 14 patients (mean age, 68.6; range, 34-85 years) who underwent TAE of the corona mortis for managing hemorrhage following pelvic fracture from September 2018 to March 2023. Medical records' data included clinical manifestation, injury severity score, hemodynamic stability, length of stay in intensive care unit, transfusion requirement, complications related to the TAE, and clinical outcomes. Of 14 patients that underwent abdominopelvic computed tomography before the TAE, 12 demonstrated positive imaging findings for bleeding including pseudoaneurysm and contrast media extravasation. Thirteen exhibited ipsilateral fracture of the superior ramus fracture, all had a positive sign of bleeding and underwent super-selective TAE of the corona mortis to control the bleeding. Overall, technical success was achieved in all 14. None of the patients demonstrated any procedure-related complications. TAE of the corona mortis is a safe and effective method for controlling hemorrhage following pelvic bone fractures. In particular, fractures involving the superior pubic ramus or pubic acetabulum warrant close attention to bleeding from the AOA, known as the corona mortis.
本研究旨在评估经导管动脉栓塞术(TAE)治疗骨盆钝性创伤出血时,对异常闭孔动脉(AOA)中死亡冠的安全性和有效性。这项回顾性分析纳入了2018年9月至2023年3月期间因骨盆骨折后出血接受死亡冠TAE治疗的14例患者(平均年龄68.6岁;范围34 - 85岁)的数据。病历数据包括临床表现、损伤严重程度评分、血流动力学稳定性、重症监护病房住院时间、输血需求、与TAE相关的并发症以及临床结局。在14例接受TAE前进行腹盆腔计算机断层扫描的患者中,12例显示出包括假性动脉瘤和造影剂外渗在内的出血阳性影像学表现。13例表现为耻骨上支骨折的同侧骨折,均有出血阳性体征,并接受了死亡冠的超选择性TAE以控制出血。总体而言,14例患者全部取得技术成功。所有患者均未出现任何与手术相关的并发症。死亡冠TAE是控制骨盆骨折后出血的一种安全有效的方法。特别是,涉及耻骨上支或耻骨髋臼的骨折需要密切关注来自被称为死亡冠的AOA的出血情况。