Endovascular management of haemorrhage in pelvic trauma

Successful management of severe pelvic trauma represents one of the most challenging clinical problems faced by trauma clinicians. These patients often have multisystem injuries representing numerous competing issues, exsanguination representing a significant number of preventable deaths. Traditional operative approaches to pelvic bleeding have largely been superseded by endovascular management. Angiographic embolisation is a core endovascular technique that has been adopted into modern management algorithms for pelvic trauma. The resurgence of interest in REBOA has the potential to contribute further endovascular benefits to this patient cohort. Whilst both of these techniques have been described and used for quite some time, their utilisation has been increasing in recent times as the endovascular technology, and evidence supporting its use, continues to advance and progress. This paper aims to provide readers a contemporary overview on endovascular adjuncts used in the management of pelvic haemorrhage from trauma.