Contemporary Role of Embolization of Solid Organ and Pelvic Injuries in Polytrauma Patients

Frontiers in Surgery

Nikolaos D. Ptohis¹  George Karydas¹  Iliana Mousogianni¹  Miltiadis Gravanis¹  Efthymios D. Avgerinos²  Adham N. Abou Ali²  Georgios Charalampopoulos³  Dimitrios Filippiadis³  Stamatina Pagoni⁴ 

[1] Department of Interventional Radiology, General Hospital of Athens “G. Gennimatas”, Athens, Greece;Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States;Second Department of Radiology, General University Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, Athens, Greece;Third Department of Internal Medicine, General Hospital of Athens “G. Gennimatas”, Athens, Greece;

关键词: angiography;    embolization;    trauma;    abdominopelvic;    emergency;   

DOI  :  10.3389/fsurg.2017.00043

来源: DOAJ

【 摘 要 】

Abdominopelvic trauma (APT) remains a leading cause of morbidity and mortality in the 15- to 44-year-old age group in the Western World. It can be life-threatening as abdominopelvic organs, specifically those in the retroperitoneal space, can bleed profusely. APT is divided into blunt and penetrating types. While surgery is notably considered as a definitive solution for bleeding control, it is not always the optimum treatment for the stabilization of a polytrauma patient. Over the past decades, there has been a shift toward more sophisticated strategies, such as non-operative management of abdominopelvic vascular trauma for haemodynamically stable patients. Angiographic embolization for bleeding control following blunt and/or penetrating intra- and retroperitoneal injuries has proven to be safe and effective. Embolization can achieve hemostasis and salvage organs without the morbidity of surgery, and the development and refinement of embolization techniques has widened the indications for non-operative treatment in solid organ injury. Moreover, advances in computed tomography provided more efficient scanning times with improved image quality. While surgery is still usually recommended for patients with penetrating injuries, non-operative management can be effectively used as well as an alternative treatment. We review indications, technical considerations, efficacy, and complication rates of angiographic embolization in APT.

【 授权许可】

Unknown