Limiting Vascular Inflow Post-Pelvic Injury Does Not Lead to Increased Ischemic Complications

Artigue M, Schroeppel T, Sheehan B., et al. Does Pelvic Angioembolization Increase Pelvic Ischemic Complication? A Multicenter American Association for the Surgery of Trauma Study. J Am Coll of Surg. 2025; in press.

Healthcare professionals are divided about whether pelvic angioembolization (PAE) causes ischemic complications of the pelvis and if selective versus non-selective embolization influences the risk of these complications. 

Artigue, from the University of California Irvine, and colleagues conducted the largest study to date of blunt pelvic fracture patients undergoing angiography. In their multicenter prospective observational study, they looked at 460 patients with pelvic fractures following blunt trauma who underwent angiography. The patients were divided into four groups, ranging from no intervention to the most aggressive intervention.

Among the 460 patients observed over 55 months (December 2017–June 2022) in 27 institutions, 45 patients (9.8%) had pelvic ischemic complications, including four (5.4%) who did not have embolization, 24 (10.0%) who selected embolization, 11 (15.1%) in the unilateral nonselective embolization group, and six (8.8%) in the bilateral nonselective embolization group. 

Because there were no significant differences in complication rates on either univariate or multivariable analyses, the authors concluded that limiting vascular inflow post-injury via PAE will not lead to increased pelvic ischemic complications.