PERCUTANEOUS TRANSCATHETER EMBOLIZATION IN MULTIPLY INJURED PATIENTS WITH PELVIC RING DISRUPTION ASSOCIATED WITH SEVERE HEMORRHAGE AND COAGULOPATHY

Six multiply injured patients with pelvic fractures were treated by pe rcutaneous transcatheter embolization during a 10 month period. Diagno sis and therapy were carried out early in two cases (first day of admi ssion into the trauma unit). Three patients were treated on the second day after admission. The inst patient was embolized on the third day. Two patients underwent one and two remote embolizations. Embolization was indicated due to uncontrolled haemorrhaging, requiring large volu mes of packed erythrocytes (median: 11.3) and fresh frozen plasma unit s (median: 6.8). Three patients had severe coagulopathy (disseminated intravascular coagulation). From two to 12 arteries were embolized per patient (median: 5). After successful transcatheter embolization, the circulation and coagulation stabilized rapidly without recurrence of haemorrhage or coagulopathy.