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To assess the utility of selective external iliac artery (EIA) angiography and the frequency of injury to branches of the EIA in cases of blunt pelvic trauma. A retrospective review of pelvic angiograms in 66 patients with blunt pelvic trauma was conducted over a 12-month period. Pelvic and femur fracture patterns were correlated to the presence of EIA injury. Pelvic arteriography was compared versus selective EIA angiography for the detection of arterial injury. Fifty-four of 66 patients (82%) exhibited pelvic arterial injury or elicited enough suspicion for injury to warrant embolization. Internal iliac artery embolization was performed in 50 of 66 (76%). EIA branch injury was identified in 11 of 66 patients (17%), and 10 were successfully embolized. EIA branch vessel injury was identified more frequently when there was ipsilateral intertrochanteric fracture (P = .07) or ipsilateral ilium fracture (P = .07). The sensitivity of nonselective pelvic angiography in the detection of EIA branch vessel injury was 45%. EIA branch injury occurs in a substantial fraction of patients with blunt pelvic trauma who undergo pelvic angiography. Selective EIA angiography should be considered in all patients undergoing pelvic angiography in this situation. Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.


Guy E Johnson, Claire K Sandstrom, Matthew J Kogut, Christopher R Ingraham, Peter G Stratil, Karim Valji, Nghia J Vo, David Glickerman, Daniel S Hippe, Siddharth A Padia. Frequency of external iliac artery branch injury in blunt trauma: improved detection with selective external iliac angiography. Journal of vascular and interventional radiology : JVIR. 2013 Mar;24(3):363-9

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PMID: 23433412

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