In a life-threatening emergency, interventional radiologists provide trauma treatment through embolization, a technique that blocks blood flow and stops bleeding.
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 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 40 years.
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.
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.
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 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 trauma and are a new way to repair and shore up the artery instead of open surgical repair. 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.