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The role of interventional radiology in abdominopelvic trauma
Anna Maria Ierardi1, Ejona Duka1, Natalie Lucchina1
11 Interventional Radiology Unit, Radiology Department, Uninsubria, Varese, Italy.
Insights
Arterial embolization is a vital, minimally invasive treatment for severe abdominopelvic bleeding in trauma patients. This technique stabilizes hemodynamics, reduces mortality, and preserves organ function, often replacing traditional surgery.
Area of Science:
- Interventional Radiology
- Trauma Surgery
- Emergency Medicine
Background:
- Computed tomography (CT) has largely replaced angiography for trauma diagnosis.
- Angiography is now primarily considered for therapeutic interventions.
- Arterial embolization is a critical life-saving procedure for abdominopelvic hemorrhage.
Purpose of the Study:
- To review the technical aspects, efficacy, and complication rates of arterial embolization in trauma patients.
- To evaluate the role of percutaneous transarterial embolization in managing high-grade abdominopelvic injuries.
- To compare the benefits of embolization with surgical interventions in polytrauma stabilization.
Main Methods:
- Review of current literature on transarterial embolization techniques.
- Analysis of data regarding hepatic, splenic, renal, and pelvic embolization in trauma.
- Evaluation of outcomes including mortality rates, hemodynamic stabilization, and organ preservation.
Main Results:
- Percutaneous transarterial embolization effectively controls active bleeding in high-grade abdominopelvic injuries.
- Embolization reduces the failure rate of non-operative management and preserves organ function.
- The procedure offers advantages of mini-invasivity and repeatability compared to surgery.
Conclusions:
- Arterial embolization is a cornerstone in managing traumatic abdominopelvic hemorrhage.
- It provides hemodynamic stabilization and reduces mortality in severe trauma cases.
- Embolization is a safe and effective alternative to surgery, preserving organ viability.
Abstract:
The management of trauma patients has evolved in recent decades owing to increasing availability of advanced imaging modalities such as CT. Nowadays, CT has replaced the diagnostic function of angiography. The latter is considered when a therapeutic option is hypothesized. Arterial embolization is a life-saving procedure in abdominopelvic haemorrhagic patients, reducing relevant mortality rates and ensuring haemodynamic stabilization of the patient. Percutaneous transarterial embolization has been shown to be effective for controlling ongoing bleeding for patients with high-grade abdominopelvic injuries, thereby reducing the failure rate of non-operative management, preserving maximal organ function. Surgery is not always the optimal solution for stabilization of a patient with polytrauma. Mini-invasivity and repeatability may be considered as relevant advantages. We review technical considerations, efficacy and complication rates of hepatic, splenic, renal and pelvic embolization to extrapolate current evidence about transarterial embolization in traumatic patients.
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