Embolization Technique Blocks Blood Flow and Stops Hemorrhaging–A Life-Threatening Emergency
Any level-one trauma center will have an interventional radiologist available as part of the trauma team. Embolization is a well-established interventional radiology technique that is used to treat emergency trauma victims with massive bleeding, to control hemorrhage after childbirth, and as a treatment prior to surgery to decrease blood loss. It has been used for over 30 years.
The Embolization Technique
The interventional radiologist makes a tiny nick in the skin, about the size of a pencil tip, and inserts a catheter into the artery. Using real-time imaging, the physician guides the catheter through the artery and then releases clotting agents (coils, particles, gel, or foam) into the blood vessels, slowing the blood flow and stopping the hemorrhage from the inside out.
Pelvic angiogram shows
active bleeding from the left
internal pudendal artery.
Angiogram shows no active
bleeding after gelfoam
The State-of-the-Art in Emergency Trauma Care
Interventional radiologists also can inflate a balloon inside the artery, just like in angioplasty, to stop the hemorrhaging and stabilize the patient so the surgeon can treat a wound, such as a gunshot wound. Often with massive bleeding, there is so much blood coming at the surgeon that it is impossible for him or her to see the wound from the outside in order to repair it.
Since interventional radiologists visualize what they are doing from the inside of the vessel using imaging, they can see the blood supply, stop the bleeding, and pinpoint the location of the wound for the surgeon or for embolization treatment. There also are certain kinds of hemorrhage that can't be controlled with surgery. For example, pelvic trauma and the arteries that go to the brain are not treatable surgically. In maxillofacial injuries, often the jaw is in the way and the surgeon can't get to the injury, but the interventional radiologist can.
Some of the treatments interventional radiologists provide are a less invasive options than surgical removal of all or part of the organ, such as in liver trauma and spleen trauma. One of the more commonly performed embolizations is for hemorrhage after childbirth. This can be caused by a torn artery, arteries that don't constrict as they should, or from bleeding from the placenta. This is a life-threatening emergency, and without the interventional radiologist, the only other treatment is emergency hysterectomy.
Interventional radiologists treat nearly everywhere in the body-internal organs, blood vessels, head, neck, back, pelvis and inaccessible areas in the body. Stent grafts are the newest interventions for emergency trauma and are a new way to repair and shore up the artery instead of open surgical repair.
Interventional Radiologists Treat Soldiers Hurt in Combat
Military facilities also have interventional radiology suites, also known as angiosuites, available with the imaging equipment and supplies needed for interventional radiologists to treat soldiers with traumatic wounds.
Reprinted with permission of the Society of Interventional Radiology © 2004, www.SIRweb.org. All rights reserved.