Therapeutic Arterial Embolization in Trauma

Acute and Chronic Traumatic Arteriovenous Fistulae in Civilians

“…Gewertz et al have described the technique previously." After 1977, all carotid-cavernous fistulae were treated successfully with a combination of embolization and surgical ligation of the 16 internal carotid artery after preliminary EC-IC bypass. Internal carotid artery ligation or repair was performed after EC-IC bypass in two patients with carotid-jugular fistulae at the base of the skull (Fig 4).…”

“Interventional angiography.” A possible role in intraoperative balloon occlusion catheterization of lacerated pelvic arteries

“…However, in the management of arterial injury with associated retroperitoneal hematoma, the efficacy of transcatheter angiographic embolization has been documented by many previous investigators (1,3,4,(9)(10)(11)(12)(15)(16)(17)(18). In fact, the current standard of treatment for retroperitoneal medium-sized vessel lacerations suspected at the time of laparotomy is angiographic embolization (10,11,16,17).…”

“…In fact, the current standard of treatment for retroperitoneal medium-sized vessel lacerations suspected at the time of laparotomy is angiographic embolization (10,11,16,17). Autogenous blood clot or Gelfoam injected through the catheter is a commonly employed technique (4,10,16,17). It is felt that the use of particulate embolization may help prevent recurrence of hemorrhage through distal collateral circulation as may occur when balloons or coils are used (16,18).…”

Transcatheter Embolization in the Treatment of Hemorrhage in Pelvic Trauma

“…One large syringe is left on the stop-cock as a reservoir for the resultant 1-to 3-mm diameter particles, which are then injected with a 1-to 3-mm syringe under fluoroscopic guidance. 73,74 The size of the syringe depends on the flow rate in the artery; as flow slows, smaller volumes allow better control to avoid reflux. Alternative particulate emboli are polyvinyl alcohol (PVA) (Contour, Boston Scientific/Medi-tech, Watertown, MA) and tris-acryl particles (Embospheres, Biosphere Medical, Rockland, MA).…”

“…Embolization is terminated when injections begin to reflux, when there is stasis of contrast medium injected in the desired vessel, and when extravasation is no longer seen on fluoroscopy 1,73 . After a completion angiogram of the treated vessel, collateral arteries to the injured vascular bed are assessed and further embolization performed, if necessary (Figs.…”