Characterization and outcomes of iliac vessel injury in the 21st century: a review of the National Trauma Data Bank

Vasc Endovascular Surg. 2013 Jul;47(5):325-30. doi: 10.1177/1538574413487260. Epub 2013 May 6.

Abstract

Introduction: Iliac vessel trauma (IVT) is traditionally associated with high mortality. We evaluated a modern series of patients with IVT to assess current outcomes and endovascular therapy use.

Methods: We performed a retrospective review of the National Trauma Data Bank. Patients with IVT were stratified by blunt and penetrating mechanism and arterial and venous injury.

Results: In blunt IVT, there was no significant difference in mortality between those with and without pelvic fractures (odds ratio [OR] 0.61, 95% confidence interval [CI] 0.36-1.06). In penetrating IVT, combined arterial and venous IVT was associated with higher mortality (OR 1.70, 95% CI 1.06-2.70) compared to isolated arterial IVT. Isolated venous IVT was associated with lower mortality (OR 0.55, 95% CI 0.35-0.85) compared to isolated arterial IVT. Endovascular stenting was utilized in 11.3% of blunt IVT with pelvic fractures, 6.3% of blunt IVT without pelvic fractures, and 1.8% of penetrating IVT.

Conclusion: Iliac Vessel Trauma has significant mortality. Endovascular intervention for IVT is applied sparingly.

Keywords: iliac artery; iliac vein; vascular trauma.

MeSH terms

  • Adult
  • Chi-Square Distribution
  • Embolization, Therapeutic
  • Endovascular Procedures* / adverse effects
  • Endovascular Procedures* / instrumentation
  • Endovascular Procedures* / mortality
  • Female
  • Fractures, Bone / mortality
  • Fractures, Bone / therapy
  • Humans
  • Iliac Artery / injuries*
  • Iliac Artery / surgery*
  • Iliac Vein / injuries*
  • Iliac Vein / surgery*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Pelvic Bones / injuries
  • Retrospective Studies
  • Risk Factors
  • Stents
  • Time Factors
  • Treatment Outcome
  • United States
  • Vascular System Injuries / diagnosis
  • Vascular System Injuries / mortality
  • Vascular System Injuries / surgery
  • Vascular System Injuries / therapy*
  • Wounds, Nonpenetrating / diagnosis
  • Wounds, Nonpenetrating / mortality
  • Wounds, Nonpenetrating / surgery
  • Wounds, Nonpenetrating / therapy*
  • Wounds, Penetrating / diagnosis
  • Wounds, Penetrating / mortality
  • Wounds, Penetrating / surgery
  • Wounds, Penetrating / therapy*