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Trauma in the Great Vessels: from the Aorta to the Pelvis

  • Vascular Interventional Radiology (O Zurkiya, Section Editor)
  • Published:
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Abstract

Purpose of Review

This review will focus on common interventional techniques in treating traumatic injuries. It will showcase the various methods and options for treatment of injuries involving the aorta, solid organs, and pelvic vasculature.

Recent Findings

Angiography and the development of transcatheter techniques and percutaneous interventions have allowed interventional radiologists to be on the front line in the management of trauma patients. Combined with the advances in cross sectional imaging, the interventional radiologist is an integral member of the medical team. Percutaneous interventions for life-threatening hemorrhages have spared patients the associated morbidity of open surgery. Endovascular repair of vessel injuries and embolization of solid organ injuries have continued to evolve into first line treatments in the acutely ill patient.

Summary

This review article will highlight the interventional radiologist’s vital role in the setting of trauma and emerging techniques in the rapidly evolving field of interventional radiology.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. • Gould J, Vedantham S. The role of interventional radiology in trauma. Semin Intervent Radiol. 2006;23:270–8. This reference provides an excellent description of the changing role of IR in trauma

    Article  Google Scholar 

  2. Wintermark M, Wicky S, Schnyder P. Imaging of acute traumatic injuries of the thoracic aorta. Eur Radiol. 2002;12:431–42.

    Article  Google Scholar 

  3. Alkadhi H, Wildermuth S, Desbiolles L, et al. Vascular emergencies of the thorax after blunt and iatrogenic trauma: multi-detector row CT and three-dimensional imaging. Radiographics. 2004;24:1239–55.

    Article  Google Scholar 

  4. Homma H, Yukioka T, Ishimaru S, et al. Two-year followup after multiple injuries treated with endovascular stentgrafting of aorta and transcatheter arterial embolization of spleen: minimal invasive surgery for an elderly patient. J Trauma. 2002;52:382–6.

    PubMed  Google Scholar 

  5. Dent D, Alsabrook G, Erickson BA, et al. Blunt splenic injuries: high nonoperative management rate can be achieved with selective embolization. J Trauma. 2004;56:1063–7.

    Article  Google Scholar 

  6. Bessoud B, Denys A, Calmes JM, et al. Non-operative management of traumatic splenic injuries: is there a role for proximal splenic artery embolization? AJR Am J Roentgenol. 2006;186:779–85.

    Article  Google Scholar 

  7. Haan JM, Bochicchio GV, Kramer N, Scalea TM. Nonoperative management of blunt splenic injury: a 5-year experience. J Trauma. 2005;58:492–8.

    Article  Google Scholar 

  8. Killeen KL, Shanmuganathan K, Boyd-Kranis R, Scalea TM, Mirvis SE. CT findings after embolization for blunt splenic trauma. J Vasc Interv Radiol. 2001;12:209–14.

    Article  CAS  Google Scholar 

  9. Schwartz RA, Teitelbaum GP, Katz MD, Pentecost MJ. Effectiveness of transcatheter embolization in the control of hepatic vascular injuries. J Vasc Interv Radiol. 1993;4:359–65.

    Article  CAS  Google Scholar 

  10. Hagiwara A, Sakaki S, Goto H, et al. The role of interventional radiology in the management of blunt renal injury: a practical protocol. J Trauma. 2001;51:526–31.

    CAS  PubMed  Google Scholar 

  11. Hak DJ. The role of pelvic angiography in evaluation and management of pelvic trauma. Orthop Clin North Am. 2004;35:439–43.

    Article  Google Scholar 

  12. Agolini SF, Shah K, Jaffe J, Newcomb J, Rhodes M, Reed JF. Arterial embolization is a rapid and effective technique for controlling pelvic fracture hemorrhage. J Trauma. 1997;43:395–9.

    Article  CAS  Google Scholar 

  13. Eastridge BJ, Starr A, Minei JP, O’Keefe GE. The importance of fracture pattern in guiding therapeutic decision-making in patients with hemorrhage shock and pelvic ring disruptions. J Trauma. 2002;53:446–51.

    Article  Google Scholar 

  14. Yoon W, Kim JK, Jeong YY, Seo JJ, Park JG, Kang HK. Pelvic arterial hemorrhage in patients with pelvic fractures: detection with contrast-enhanced CT. Radiographics. 2004;24:1591–606.

    Article  Google Scholar 

  15. Richardson P, Mirvis SE, Scorpio R, Dunham CM. Value of CT in determining the need for angiography when findings of mediastinal hemorrhage on chest radiographs are equivocal. AJR Am J Roentgenol. 1991;156:273–9.

    Article  CAS  Google Scholar 

  16. Hagiwara A, Minakawa K, Fukushima H, Murata A, Masuda H, Shimazaki S. Predictors of death in patients with life-threatening pelvic hemorrhage after successful transcatheter arterial embolization. J Trauma. 2003;55:696–703.

    Article  Google Scholar 

  17. Grimm MR, Vrahas MS, Thomas KA. Pressure-volume characteristics of the intact and disrupted pelvic retroperitoneum. J Trauma. 1998;44:454–9.

    Article  CAS  Google Scholar 

  18. Miller PR, Moore PS, Mansell E, Meredith JW, Chang MC. External fixation or arteriogram in bleeding pelvic fracture: initial therapy guided by markers of arterial hemorrhage. J Trauma. 2003;54:437–43.

    Article  Google Scholar 

  19. Ramirez J, Velmajos GC, Best CR, Chan LS, Demetriades D. Male sexual function after bilateral internal iliac artery embolization for pelvic fracture. J Trauma. 2004;56:734–41.

    Article  Google Scholar 

  20. Yasumura K, Ikegami K, Kamohara T, Nohara Y. High incidence of ischemic necrosis of the gluteal muscle after transcatheter angiographic embolization for severe pelvic fracture. J Trauma. 2005;58:985–90.

    Article  Google Scholar 

  21. •• Chung J, Owen R, Turnbull R, et al. Endovascular repair in traumatic thoracic aortic injuries: comparison with open repair. J Vasc Interv Radiol. 2008;19:479–86. Explores the changing management of TAI

    Article  Google Scholar 

  22. • Imbrogno B, Ray C. Splenic artery embolization in blunt trauma. Semin Intervent Radiol. 2012;29(2):147–9. Excellent overview of splenic embolization

    Article  Google Scholar 

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Correspondence to Constantino Peña.

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The authors declare no conflicts of interest relevant to this manuscript.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Vascular Interventional Radiology

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Bordlee, B., Schiro, B. & Peña, C. Trauma in the Great Vessels: from the Aorta to the Pelvis. Curr Trauma Rep 3, 207–211 (2017). https://doi.org/10.1007/s40719-017-0100-4

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  • DOI: https://doi.org/10.1007/s40719-017-0100-4

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