Questions and Answers
What is the most common complication associated with pelvic embolization?
Which of the following factors influences the decision to perform selective or nonselective embolization?
What percentage of patients may require repeat embolization due to complications?
What rare complication can occur from bilateral internal iliac artery embolization?
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Which of the following complications is less commonly reported after pelvic embolization?
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What is the primary method suggested to minimize the risk of gluteal necrosis during pelvic embolization?
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Which of the following is NOT a reported complication of bilateral internal iliac artery embolization?
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Identify a less common complication associated with internal iliac artery embolization.
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What is the level of uncertainty regarding erectile dysfunction as a complication of bilateral internal iliac artery embolization?
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Which complication is related to the site of access during the embolization procedure?
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Study Notes
Embolization in Pelvic Trauma
- Recurrent Hemorrhage: Most common complication requiring repeat intervention occurs in 7-11% of patients post-embolization.
- Causes of Rebleed: May include new bleeding sites not identified initially, early recanalization, or persistent bleeding from missed injuries.
Complications of Embolization
- Ischemic Necrosis: Can affect gluteal, perineal muscles, or rectum; rare instances of bladder ischemia reported.
- Avascular Necrosis: Bilateral internal iliac artery embolization can lead to avascular necrosis of the femoral head.
- Peripheral Nerve Injury: Paresthesia and/or paresis may occur, though the risk of erectile dysfunction post-embolization is unclear.
Treatment Considerations
- Transcatheter Embolization: Recommended for hemodynamically stable patients responsive to resuscitation; type of embolization (selective vs. non-selective) depends on urgency and injury type.
- Gelfoam Slurry: Use of Gelfoam improves outcomes by minimizing gluteal necrosis risk, especially when vasopressors are avoided prior to embolization.
Complications from Contrast and Access
- Contrast-Related Issues: Potential complications include contrast allergy, contrast-induced nephropathy, access-site infection, hematomas, and pseudoaneurysm formation.
Recent Findings
- Study Data: Review of 61 patients undergoing bilateral internal iliac artery embolization with Gelfoam slurry showed no related ischemic complications.
- Historical Studies: Earlier studies reported no ischemic complications associated with similar embolization techniques; focus on minimizing morbidity and mortality through early intervention.
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Description
Test your knowledge on embolization and the complications that may arise after the procedure. This quiz includes key concepts regarding recurrent hemorrhage and the importance of identifying bleeding sites during interventions.
