Keywords:
Emergency, Trauma, Interventional vascular, CT, CT-Angiography, Catheter arteriography, Embolisation, Stents, Dissection, Haemorrhage
Authors:
C. Krestan, S. Arbes, F. Wolf, M. Funovics; Vienna/AT
DOI:
10.1594/ecr2013/C-2149
Results
The total number of chest MDCT´s in the emergency room after acute trauma was 395.
In 19 patients (4.8%),
interventional radiological procedures were performed.
In seven patients (37%),
branches of the iliac or renal artery were selectively embolized.
In ten patients (53%),
an endovascular thoracic stentgraft was applied due to type-B-dissection or traumatic transsection of the thoracic aorta.
Fig.1.
and 2 show contrast enhanced axial and coronal MPRs of a traumatic aortic transsection and pseudoaneurysm after an MVA in a 30 year old male.
The patient was successfully treated with endovascular aortic repair with a thoracic stentgraft (MedtronicValiant).
Completion angiography demonstrates regular position of the stentgraft (Fig.3),
(3).
In Fig.4 axial contrast enhanced MDCT shows active bleeding after pelvic ring fracture and distortion of the symphysis in a 54 year old male after blunt trauma.
This patient was hemodymamically unstable and DSA (Fig.5) confirms arterial bleeding.
Endovascular treatment with superselective coiling (IDC,
BostonScientific) of branches of the internal ilical artery stopped the bleeding (Fig.6),
(4,5).