Damage Control Interventional Radiology in Liver Trauma: A Comprehensive Review

Area of Science:

• Trauma Surgery
• Interventional Radiology
• Hepatobiliary Medicine

Background:

• Liver injuries are common in abdominal trauma.
• Non-operative management (NOM) with transarterial embolization (TAE) is standard for stable patients.
• Operative management (OM) is standard for hemodynamically unstable patients.

Purpose of the Study:

• Evaluate the efficacy of TAE as a primary treatment for hemodynamically unstable/transient responder liver trauma patients.
• Assess TAE as a sole or adjunct treatment for hemorrhagic liver lesions.
• Clarify definitions of hemodynamic instability and transient response in literature.

Main Methods:

• Systematic literature review of published studies.
• Analysis of outcomes for TAE in hemodynamically unstable/transient responder liver trauma.
• Focus on hemorrhagic vascular lesions and treatment combinations.

Main Results:

• Transarterial embolization (TAE) demonstrates favorable outcomes in hemodynamically unstable/transient responder liver trauma patients.
• TAE can be used effectively as a primary or adjunctive therapy.
• Significant debate persists regarding the precise definitions of "unstable" and "transient responder" patients.

Conclusions:

• Transarterial embolization (TAE) is a viable treatment option for hemodynamically unstable liver trauma.
• Standardized definitions for hemodynamic instability and transient response are crucial for future research and clinical practice.
• Further consensus is needed to optimize the endovascular management of severe liver injuries.