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. 2006 Sep;23(3):270-8.
doi: 10.1055/s-2006-948766.

The role of interventional radiology in trauma

Jennifer E Gould  1 , Suresh Vedantham
Affiliations

The role of interventional radiology in trauma

Jennifer E Gould et al. Semin Intervent Radiol. 2006 Sep.

Abstract

Since the development of angiography and transcatheter techniques, interventional radiology has played an important role in the management of trauma patients. The ability to treat life-threatening hemorrhage with transcatheter embolization has spared countless patients the morbidity of surgery. Advances in cross-sectional imaging and increases in understanding of which patients will best benefit from embolization promise to further refine the interventional radiologist's role. As the applications of transcatheter therapy broaden to include embolization of unstable patients with solid organ injuries and endovascular repair of major arterial injuries, the interventional radiologist must be increasingly prepared to provide prompt, efficient, and high-quality service.

Keywords: Trauma; angiography; embolization.

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Figures

Figure 1
Figure 1
Active extravasation is well seen on CT (A) in the right hepatic lobe following a gunshot wound to the right upper quadrant. Angiography confirms the extravasation (B), which was successfully treated with TAE using coils superselectively deployed in the bleeding vessel with preservation of surrounding branches (C). (Images courtesy of James Duncan, M.D., Ph.D.)
Figure 2
Figure 2
Blunt chest trauma resulted in a traumatic injury of the right brachiocephalic artery with pseudoaneurysm formation. The intraluminal filling defect proximal to the vertebral artery origin was felt to preclude safe endovascular treatment and was confirmed to be thrombus at surgery. (Image courtesy of Colin Derdeyn, M.D.)
Figure 3
Figure 3
Blunt trauma to the pelvis resulted in injury of the left internal iliac artery with a contrast blush in the left pelvis (A) confirmed as a pseudoaneurysm of the proximal anterior division branch (B). Marked irregularity of the posterior division branch was not appreciated on CT. Both injuries were treated with coil embolization.
Figure 4
Figure 4
Multiple small pseudoaneurysms of the right internal iliac branches are present on this pelvic angiogram. The diffuse nature of the injury makes gelfoam “scatter” TAE optimal.
Figure 5
Figure 5
Multiple injuries of the extremities are possible from trauma including probable dissection with intramural hematoma (A), transection with pseudoaneurysm formation (B), and active extravasation (C) treated with TAE (D). (Images A, C, and D courtesy of Michael Darcy, M.D. Image B courtesy of James Duncan, M.D., Ph.D.)
See this image and copyright information in PMC

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