In a life-threatening emergency, interventional radiologists provide trauma treatment through embolization, a technique that blocks blood flow and stops hemorrhaging. Embolization is a well-established interventional radiology technique that is used to treat trauma victims with massive bleeding, to control hemorrhage after childbirth and as a treatment prior to surgery to decrease blood loss and most level-one trauma centers will have an interventional radiologist available as part of the trauma team.
How do IRs treat trauma and bleeding?
First, the interventional radiologist makes a tiny nick in the skin and inserts a catheter into the artery. Using real-time imaging, the physician guides a 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.
Often with massive bleeding, such as a gunshot wound, 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. The IR can also inflate a balloon inside the artery to stop the hemorrhaging and stabilize the patient for surgery.
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.
Read about the key role IR plays on a hospital trauma team
On the morning of June 14, 2017, people around the country heard news of a shooting in Alexandria, Virginia, at the Republican baseball team practice for the annual Congressional Baseball Game for Charity, a bipartisan event scheduled for the following day ... Arshad A. Khan, MD, FSIR, the senior interventional radiology staff physician at MedStar, was the trauma team IR on duty that morning when the IR team was informed that there had been a mass shooting and that they should prepare the IR suites for patients. Around 8:15 a.m., the trauma surgical team alerted IR that they may need to bring a patient to IR for embolization ..." Read the full article in IR Quarterly.
How do IRs treat organ and wound trauma?
Some treatments interventional radiologists provide are a less invasive option than surgical removal of all or part of the organ, such as in liver trauma and spleen trauma. One of the more commonly performed embolization 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.
Military facilities and field hospitals often have interventional radiology suites available with the imaging equipment and supplies needed for interventional radiologists to treat soldiers with traumatic wounds.
Disclaimer: SIR is providing this information as a public service. SIR assumes no liability, legal, financial or otherwise for the accuracy of this information or the manner in which it is used. SIR does not offer medical advice. This information is being provided for informational purposes only and should not be used to replace professional medical advice. It is best to seek advice and attention from your physician or qualified health care professional.