EMBOLIZATION FOR TRAUMA

What are the indications?

Severe bleeding as a consequence of polytrauma most often happens in the abdomen or pelvis. Embolization is usually the first line of treatment.

Procedure

Your attending trauma surgeon will organize CT Angiogram before the intervention in order to better delineate vascular anatomy and identify the site of bleeding (so-called “vascular blush”). The results of this test will be analyzed by the interventional radiologist who will then plan the appropriate treatment.

The procedure is similar to general angiography and embolization.

The radiologist will, with a help of X-rays, place the tiny tube (micro catheter) into the artery of interest and administer contrast to demonstrate the site of bleeding.

The preferred agents for occlusion of the bleeding artery are micro coils, which will permanently occlude selected artery combined with gelatin sponge aiming to decrease the pressure in the whole vascular territory and prevent repeated episodes of bleeding.

Is there any additional risk?

The possibility that the embolization agent can dislodge into the arterial system and deprive healthy tissue of blood supply is minimal. It is avoided by the careful positioning of the micro catheter supraselectively next to the bleeding spot.

Sometimes, the anatomy of the bleeding artery and its branches may be too complex for the safe placement of tube. In that case the radiologist will advice you that the procedure is not technically feasible and your attending doctor will present you with the other (possibly surgical) treatment options.

Very seldom you may feel mild pain 24-48 hours after the procedure, which will necessitate administration of painkillers.

The other risks are similar to general angiography and embolization.

 

Leave a Reply