A trauma patient with pelvic fracture (open-book) has profuse arterial hemorrhage on CT. Angiography reveals bilateral internal pudendal artery bleeding. What is the first-line radiological intervention?
- A Transcatheter arterial embolization (TAE) of bleeding vessels ✓
- B External iliac artery ligation
- C Percutaneous nephrostomy
- D Emergency aortic balloon occlusion alone
Correct answer: A. Transcatheter arterial embolization (TAE) of bleeding vessels
Explanation
Transcatheter arterial embolization (TAE) is the standard interventional radiology approach for arterial pelvic bleeding in pelvic fractures when CT demonstrates active extravasation. TAE achieves hemostasis in 80–90% of cases with lower morbidity than open ligation. Temporary aortic balloon occlusion (REBOA) may be used as a bridge to definitive hemostasis but is not the primary definitive intervention. External iliac ligation is a surgical procedure reserved for cases where angioembolization fails.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
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