Bilateral internal iliac artery ligation in trauma patients with severe pelvic hemorrhage: A systematic review.
<h4>Introduction</h4>Severe pelvic hemorrhage significantly contributes to mortality in trauma patients, yet the most effective treatment for severe pelvic injuries remains unclear. This systematic review evaluates the mortality and morbidity associated with bilateral internal iliac arte...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2025-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0303476 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823856845039599616 |
|---|---|
| author | Soon Tak Jeong Do Wan Kim Wu Seong Kang |
| author_facet | Soon Tak Jeong Do Wan Kim Wu Seong Kang |
| author_sort | Soon Tak Jeong |
| collection | DOAJ |
| description | <h4>Introduction</h4>Severe pelvic hemorrhage significantly contributes to mortality in trauma patients, yet the most effective treatment for severe pelvic injuries remains unclear. This systematic review evaluates the mortality and morbidity associated with bilateral internal iliac artery ligation (BIIAL) in patients experiencing severe hemorrhage from traumatic pelvic fractures.<h4>Methods</h4>Comprehensive searches were conducted in MEDLINE PubMed, EMBASE, and Cochrane databases until February 7, 2024, to identify relevant articles. The risk of bias in observational studies was assessed using the ROBINS-I tool, which evaluates bias risk in nonrandomized intervention studies. The primary outcome was mortality following BIIAL, with the secondary outcome being complications related to the procedure.<h4>Results</h4>The review included eight studies, all observational. The overall mortality rate after BIIAL ranged from 45.0% to 76.9%. Ischemic complications from BIIAL were infrequent. A high and unclear risk of bias due to confounding and participant selection was noted across the studies. Four studies highlighted distinct indications for BIIAL compared to angioembolization. BIIAL was employed for patients with severe hemodynamic instability or when angiography was not available.<h4>Conclusion</h4>Due to geographical limitations and significant heterogeneity among the studies reviewed, the true effect size of BIIAL remains indeterminate. Nevertheless, further prospective studies with robust designs are necessary. BIIAL holds potential as a viable option when angioembolization is not accessible or in cases of critical patient instability. |
| format | Article |
| id | doaj-art-9d19a7de84c1466899058443d16a3b4a |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-9d19a7de84c1466899058443d16a3b4a2025-02-12T05:30:56ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01202e030347610.1371/journal.pone.0303476Bilateral internal iliac artery ligation in trauma patients with severe pelvic hemorrhage: A systematic review.Soon Tak JeongDo Wan KimWu Seong Kang<h4>Introduction</h4>Severe pelvic hemorrhage significantly contributes to mortality in trauma patients, yet the most effective treatment for severe pelvic injuries remains unclear. This systematic review evaluates the mortality and morbidity associated with bilateral internal iliac artery ligation (BIIAL) in patients experiencing severe hemorrhage from traumatic pelvic fractures.<h4>Methods</h4>Comprehensive searches were conducted in MEDLINE PubMed, EMBASE, and Cochrane databases until February 7, 2024, to identify relevant articles. The risk of bias in observational studies was assessed using the ROBINS-I tool, which evaluates bias risk in nonrandomized intervention studies. The primary outcome was mortality following BIIAL, with the secondary outcome being complications related to the procedure.<h4>Results</h4>The review included eight studies, all observational. The overall mortality rate after BIIAL ranged from 45.0% to 76.9%. Ischemic complications from BIIAL were infrequent. A high and unclear risk of bias due to confounding and participant selection was noted across the studies. Four studies highlighted distinct indications for BIIAL compared to angioembolization. BIIAL was employed for patients with severe hemodynamic instability or when angiography was not available.<h4>Conclusion</h4>Due to geographical limitations and significant heterogeneity among the studies reviewed, the true effect size of BIIAL remains indeterminate. Nevertheless, further prospective studies with robust designs are necessary. BIIAL holds potential as a viable option when angioembolization is not accessible or in cases of critical patient instability.https://doi.org/10.1371/journal.pone.0303476 |
| spellingShingle | Soon Tak Jeong Do Wan Kim Wu Seong Kang Bilateral internal iliac artery ligation in trauma patients with severe pelvic hemorrhage: A systematic review. PLoS ONE |
| title | Bilateral internal iliac artery ligation in trauma patients with severe pelvic hemorrhage: A systematic review. |
| title_full | Bilateral internal iliac artery ligation in trauma patients with severe pelvic hemorrhage: A systematic review. |
| title_fullStr | Bilateral internal iliac artery ligation in trauma patients with severe pelvic hemorrhage: A systematic review. |
| title_full_unstemmed | Bilateral internal iliac artery ligation in trauma patients with severe pelvic hemorrhage: A systematic review. |
| title_short | Bilateral internal iliac artery ligation in trauma patients with severe pelvic hemorrhage: A systematic review. |
| title_sort | bilateral internal iliac artery ligation in trauma patients with severe pelvic hemorrhage a systematic review |
| url | https://doi.org/10.1371/journal.pone.0303476 |
| work_keys_str_mv | AT soontakjeong bilateralinternaliliacarteryligationintraumapatientswithseverepelvichemorrhageasystematicreview AT dowankim bilateralinternaliliacarteryligationintraumapatientswithseverepelvichemorrhageasystematicreview AT wuseongkang bilateralinternaliliacarteryligationintraumapatientswithseverepelvichemorrhageasystematicreview |