Type:
Educational Exhibit
Keywords:
Trauma, Stents, Embolisation, Arterial access, CT-Angiography, Catheter arteriography, Interventional vascular, Abdomen
Authors:
S. C. Torres-Ayala1, J. Atiles2, L. garcia paredes3, A. P. Marrero González4, R. Marquez5, A. Bravo6, A. hidalgo3; 1Mayaguez, PR/US, 2Ponce/US, 3San Juan/US, 4San Juan, Puerto Rico/US, 5Mayaguez/US, 6San Juan, PR - PUERTO RICO/US
DOI:
10.1594/ecr2018/C-2302
Background
Trauma remains a leading cause of mortality worldwide and leading cause of death in people below age 44 in the US[22].
Interventional radiologist's training in transcatheter therapies and multimodality imaging have rendered these physicians indispensable to trauma teams.
Digital subtraction angiography (DSA),
transarterial embolization (TAE),
stenting and other interventional methods have changed management of trauma patients,
providing minimally invasive procedures with high success rates and low patient morbidity.
Though surgery had been gold standard for hemorrhage control, TAE has emerged as an effective,
safe option to treat solid organ and extremity vascular injuries[3].
Successful treatment rates of vascular injuries by embolization range between 87-100%[3,
23].
Studies highlight the role of angiography in the assessment of injured traumatic patients and its effectiveness in eliminating the need for surgical arterial exploration in many cases[24].
In a study by Moore,
angiographies detected major arterial injury with a 98.3% sensitivity in patients with suspected major arterial trauma[23].
Achieving both definitive diagnosis and therapy in the angiography suite,
embolization can supplant early surgical intervention,
while sparing patients of invasive procedures.
Furthermore,
the application of stent-grafts for large vessel injuries has emerged to avoid or delay complex surgical vascular repairs in unstable patients.