Selective Transcatheter Arterial Embolization of the Internal Iliac Artery Does Not Cause Gluteal Necrosis in Pelvic Trauma Patients
Bibliographic record
Abstract
OBJECTIVES: The aim of this study is to determine if selective transcatheter arterial embolization (TAE) of the branches of the internal iliac artery in patients with pelvic trauma is a risk for gluteal necrosis. DESIGN: Retrospective chart review. SETTING: Civilian Level I trauma center. PATIENTS: Twenty patients with pelvic fractures and hemorrhage. INTERVENTION: Selective and nonselective TAE of the internal iliac artery and its branches. MAIN OUTCOME MEASUREMENT: The location of all fractures was identified as well as the fracture type. Selective TAE was also distinguished from nonselective TAE. Orthopaedic surgical intervention was recorded. Cases of gluteal necrosis and wound infection were recorded as well as renal failure and anaphylactic reaction to intravenous contrast. RESULTS: Of the 551 patients identified with pelvic fractures, 20 patients were identified to have undergone TAE from January 2004 to January 2009. Of these, 18 cases were treated with selective TAE and two with nonselective unilateral TAE. No complications of gluteal muscle or pelvic skin necrosis, wound infection, renal failure, or anaphylaxis were noted in any of these cases. Average patient age was 55 years with average Injury Severity Score 17. Eleven cases underwent orthopaedic surgical procedures, eight of which involved open reduction and internal fixation of the acetabulum or hemiarthroplasty of the hip. CONCLUSIONS: Selective TAE of internal iliac branches including the gluteal arterial branches appears to be safe in patients with pelvic and acetabular fractures with and without orthopaedic surgical treatment. Nonselective TAE of the internal iliac artery may also be safe when performed unilaterally. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".