The role of endovascular treatment of pelvic XXXX bleeding in emergency settings.

@entity1 @entity174 @entity548 @entity432 @entity130
PURPOSE: To evaluate the role of endovascular treatment for controlling @entity548 in haemodynamically unstable @entity1 with @entity174 and to relate clinical efficacy to pre-procedural variables. MATERIALS AND METHODS: From March 2009 through April 2013, 168 @entity1 with major pelvic @entity130 associated with high-flow @entity548 were referred to our emergency department and were retrospectively reviewed. Pelvic arteries involved were one or more per @entity1 . Embolisation was performed using various materials (micro-coils, Spongostan, plug, glue, covered stent), and technical success, complications, treatment success, clinical efficacy, rebleeding, and mortality rates were assessed. Factors influencing clinical efficacy were also evaluated. RESULTS: The technical success rate was 100  %; no complications occurred during the procedures. Treatment was successful in 94.6  % cases, and clinical efficacy was 85.7  %. Three @entity1 had to undergo a second arteriography due to recurrent @entity548 . Fifteen @entity1 died. Pre-embolisation transfusion demand was significantly associated with clinical efficacy. CONCLUSIONS: Percutaneous embolisation of @entity548 may be considered a safe, effective, and minimally invasive therapeutic option. As haemodynamic stability is the first objective with traumatic @entity548 @entity1 , arterial embolisation can assume a primary role. On the basis of our results, pre-procedural transfusion status may be considered a prognostic factor. KEY POINTS:     The series presented is one of the largest in a single centre.     @entity432 is a life-saving procedure in @entity1 with @entity548 .     In pelvic @entity130 associated with @entity548 , prognosis is dependent upon prompt treatment.     Transfusion status is significantly related to clinical efficacy.
