Transcatheter embolization in the treatment of hemorrhage in pelvic trauma.

Massive hemorrhage related to pelvic trauma is relatively rare, but when it occurs rapid triage to therapeutic intervention is essential for survival. Traditional surgical repairs had limited success. Anatomic and clinical studies indicate that arterial hemorrhage is often identified in patients with hemodynamic instability that do not respond to initial resuscitation. Transcatheter angiography directly identifies arterial injury, and embolization can control retroperitoneal arterial hemorrhage. Stent-graft technology extends the scope of interventional therapy to include rapid and definitive repair of nonexpendable artery injury. Successful management requires coordination between multiple services and the continuation of resuscitative procedures in the angiography suite.