Figure 2.

CT angiography scan of motorcycle accident patient showing an open-book pelvic fracture with active contrast extravasation into a Retzius space hematoma (A). Bleeding from the left internal pudendal artery confirmed with selective digital subtraction angiography (B). The ensuing vasospasm makes both distal selective catheterization and the correct proximal release of coils (arrow) in the anterior division impossible; therefore, prophylactic embolization is performed with a gelatin sponge, also in consideration of a worsening of the patient’s hemodynamic status (C). Digital subtraction angiography of the external iliac artery showing active bleeding from the external pudendal artery (D), confirmed with superselective catheterization (E). Final angiogram demonstrating effective embolization with EVOH copolymer cast (arrow) (F).