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Trauma Embolization

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Essential Interventional Radiology Review

Abstract

In trauma patients, the airway, breathing, and circulation (ABCs) must always be evaluated and stabilized first. A comprehensive physical examination, followed by directed imaging, will then dictate further treatment and management. The American Association for Surgery of Trauma (AAST) grading scales help stratify and manage traumatic injuries of intra-abdominal organs, the most commonly being: spleen, liver, and kidney. Angiography and embolization are generally indicated when the patient is hemodynamically stable but has significant continued bleeding. However, in cases of suspected pelvic or extremity bleeds, hemodynamic instability and continued need for fluid resuscitation are indications for embolization. Factors predicting the failure of non-operative management include high injury severity and pre-existing organ disease or injury. When performing embolization, one must weigh the benefits and risks of proximal versus distal embolization, as well as whether to use permanent or temporary embolic agents. These choices depend on the organ of interest, whether there is ability to form collateral circulation to the organ of interest, and whether or not the bleeding can be completely sacrificed or requires reconstruction with a covered stent to maintain distal perfusion. General complications of embolization include pseudoaneurysm at the arterial puncture site, hematoma, dissection, thrombosis, infection, nontarget embolization causing infarction, and post-embolization syndrome.

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Author information

Authors and Affiliations

  1. Division of Interventional Radiology, Department of Diagnostic Radiology, Cleveland Clinic, Cleveland, OH, USA

    Justin J. Guan

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  1. Justin J. Guan
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Editors and Affiliations

  1. The Hospital for Sick Children, Toronto, Ontario, ON, Canada

    Rajat Chand

  2. Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Adam E. M. Eltorai

  3. Brown University, East Providence, RI, USA

    Terrance Healey

  4. Brown University, Providence, RI, USA

    Sun Ahn

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Guan, J.J. (2022). Trauma Embolization. In: Chand, R., Eltorai, A.E.M., Healey, T., Ahn, S. (eds) Essential Interventional Radiology Review. Springer, Cham. https://doi.org/10.1007/978-3-030-84172-0_46

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  • DOI: https://doi.org/10.1007/978-3-030-84172-0_46

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  • Online ISBN: 978-3-030-84172-0

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