Angiographic diagnosis and treatment of bleeding by selective embolization following pelvic fracture in children

Barlow, Barbara; Rottenberg, Robert W.; Santulli, Thomas V.

doi:10.1016/s0022-3468(75)80099-6

Cited by 20 publications

(5 citation statements)

References 3 publications

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“…Endovascular techniques were initially focused on age-related disease and not applied to the trauma setting until the 1970s. [ 8 9 10 ] In 2008, the first report on diagnostic and therapeutic endovascular capabilities in the management of acute wartime injury was published, demonstrating high success rates with minimal complications (3%). [11] As the clinical applicability of endovascular techniques evolved, the emergence of the resuscitative endovascular balloon occlusion of the aorta (REBOA) gained widespread use.…”

Section: Hemorrhage Controlmentioning

confidence: 99%

The polytrauma patient: Current concepts and evolving care

Lee¹,

Rasmussen

Pape

et al. 2021

OTA International: The Open Access Journal of Orthopaedic Trauma

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Principles of care in the polytraumatized patient have continued to evolve with advancements in technology. Although hemorrhage has remained a primary cause of morbidity and mortality in acute trauma, emerging strategies that can be applied pre-medical facility as well as in-hospital have continued to improve care. Exo-vascular modalities, including the use of devices to address torso hemorrhage and areas not amenable to traditional tourniquets, have revolutionized prehospital treatment. Endovascular advancements including the resuscitative endovascular balloon occlusion of the aorta (REBOA), have led to dramatic improvements in systolic blood pressure, although not without their own unique complications. Although novel treatment options have continued to emerge, so too have concepts regarding optimal time frames for intervention. Though prior care has focused on Injury Severity Score (ISS) as a marker to determine timing of intervention, current consensus contends that unnecessary delays in fracture care should be avoided, while respecting the complex physiology of certain patient groups that may remain at increased risk for complications. Thromboelastography (TEG) has been one technique that focuses on the unique pathophysiology of each patient, providing guidance for resuscitation in addition to providing information in recognizing the at-risk patient for venous thromboembolism. Negative pressure wound therapy (NPWT) has emerged as a therapeutic adjuvant for select trauma patients with significant soft tissue defects and open wounds. With significant advancements in medical technology and improved understanding of patient physiology, the optimal approach to the polytrauma patient continues to evolve.

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Section: Hemorrhage Controlmentioning

confidence: 99%

The polytrauma patient: Current concepts and evolving care

Lee¹,

Rasmussen

Pape

et al. 2021

OTA International: The Open Access Journal of Orthopaedic Trauma

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“…Similarly, numerous authors have proposed that venous bleeding is mainly responsible for blood loss associated with pelvic fractures [1,2,12,16]. Connolly and Hedberg evaluated a group of 200 patients with pelvic injuries.…”

Section: Veinsmentioning

confidence: 99%

“…Embolization Embolization of bleeding arteries by interventional radiologists has been a part of the standard procedure for managing pelvic fractures for several years, and a number of studies have indicated that the procedure is efficient [1][2][3]16]. Randomized studies do not exist for ethical reasons.…”

Section: Management Choicesmentioning

confidence: 99%

Severe Pelvic Bleeding: The Role of Primary Internal Fixation

Barootchi

Erdohelyi

2010

Eur J Trauma

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Pelvic ring injuries form part of the spectrum of polytraumaandmust be considered a potentially lethal injury with mortality rates of 10-20%. The stabilization of the unstable pelvic ring in acute resuscitation of multiply injured patients is now conventional wisdom.We aimed: (1) to design a new iliosacral (IS) screw, (2) to prove the clinical advantages of this new implant, and (3) to work out the optimal surgical strategy using this implant. Taking the demands of the above mentioned data into account, a 10 mm 2.8 mm-cannulated iliosacral screw seemed to be optimal for the special requirements. Before industrial production, finite element analysis (FEA) was performed to find out whether these screws would be enough to stabilize the posterior pelvic ring alone or not. Clinical experience led to the modification of the set of instruments, which finally yielded handy tools and implants. Building further on the surgical skills and experiences gained (by the surgeons and the O.R. personnel), we increased our capacity to perform more and more immediate pelvic fixations. Emergency pelvic stabilizationswere performed in patientswith pelvic injuries who had hemodynamic instability, despite immediate shockmanagement during the diagnostic period. During thelast eleven years, 244 patientswith Tile B3 and Cpelvic injuries have been stabilized with 10-mm diameter cannulated IS screws percutaneously posteriorly. Fortyeight hemodynamically unstable patientswere stabilized in the first 2 h with iliosacral screw fixation. The percutaneous pelvic ring stabilization with 10-mm cannulated screws provedstrongenoughin bothersome casesaswell.

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“…Recent advances in technology have expanded application of intraluminal vascular solutions to an increasing variety of vascular conditions. Endovascular technologies allow for efficacious and safe interventions to occur at decreased overall impact to patients [1][2][3][4][5]. It should be no surprise that endovascular techniques are becoming increasingly utilized for acute care vascular dilemmas in patients who are often physiologically exhausted [6].…”

Section: Introductionmentioning

confidence: 99%

Interventional Alternatives for Vascular Injury

Gilani¹

2021

Vascular Complications of Surgery and Intervention

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Angiographic diagnosis and treatment of bleeding by selective embolization following pelvic fracture in children

Cited by 20 publications

References 3 publications

The polytrauma patient: Current concepts and evolving care

The polytrauma patient: Current concepts and evolving care

Severe Pelvic Bleeding: The Role of Primary Internal Fixation

Interventional Alternatives for Vascular Injury

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