Angioembolization: Indications, Approach and Optimal Use

Angioembolization has revolutionized the management of pelvic-fracture-related hemorrhage. Along with pelvic immobilization and preperitoneal pelvic packing, angioembolization is an integral component in multidisciplinary algorithms for achieving hemostasis in severe pelvic trauma. Polytrauma, especially associated intraperitoneal injuries, adds to the complexity and complicates decisions related to the optimal care for these patients in hemorrhagic shock. The indications, timing, location, and technique for angioembolization differ based on available resources and expertise. Regional, institutional, and personal preferences add further variation to practice patterns and outcomes. While complications are associated with pelvic angioembolization, the actual causal relationship is questionable. Furthermore, angioembolization is frequently a life-saving maneuver without an effective alternative treatment. The wealth of recent literature will be pieced together to define the role that angioembolization should play in the management of pelvic fracture-related hemorrhage.