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World J Radiol. Apr 28, 2017; 9(4): 155-177
Published online Apr 28, 2017. doi: 10.4329/wjr.v9.i4.155
“Beyond saving lives”: Current perspectives of interventional radiology in trauma
Anuradha Singh, Atin Kumar, Pawan Kumar, Subodh Kumar, Shivanand Gamanagatti
Anuradha Singh, Atin Kumar, Pawan Kumar, Shivanand Gamanagatti, Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
Subodh Kumar, Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
Author contributions: Gamanagatti S contributed equally to conception, article design, and image preparation; Singh A helped with the literature search and article drafting; Kumar A helped to procure the images, and final approval of version of article to be published; Kumar P and Kumar S contributed in critical revision article concept, revision literature search and image preparation.
Conflict-of-interest statement: The authors have nothing to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shivanand Gamanagatti, MD, Additional Professor, Department of Radiodiagnosis, All India Institute of Medical Sciences, Room no 81-B, Ansari Nagar, New Delhi 110029, India. shiv223@gmail.com
Telephone: +91-11-26594567 Fax: +91-11-26588500
Received: September 25, 2016
Peer-review started: September 28, 2016
First decision: November 2, 2016
Revised: December 30, 2016
Accepted: January 16, 2017
Article in press: January 18, 2017
Published online: April 28, 2017
Processing time: 215 Days and 4.3 Hours
Abstract

Interventional radiology (IR) has become an integral part in the management of traumatic injuries. There is an ever-increasing role of IR in traumatic injuries of solid abdominal organs, pelvic and peripheral arteries to control active bleeding by therapeutic embolization or vascular reconstruction using stent grafts. Traditionally, these endovascular treatments have been offered to hemodynamically stable patients. However, in recent times endovascular approach has become preferable to surgery even in hemodynamically unstable patients with injury of surgically difficult-to-access sites. With shifting trends towards non operative management coupled with availability of the current state-of-the-art equipments, hardware and technical expertise, IR has gained an impeccable role in trauma management. However, due to lack of awareness and widespread acceptance, IR continues to remain an ocean of unexplored potentialities.

Keywords: Blunt abdominal trauma; Pelvic trauma; Peripheral arterial injury; Interventional radiology; Embolization

Core tip: Over the past two decades, there has been a paradigm shift in the management of traumatic injuries with inception of the concept of non operative management (NOM), which is followed if there are no peritoneal signs or hollow viscus injury. Interventional radiology (IR) is an extension of NOM which not only saves lives by achieving hemostasis at the site of vascular injury or difficult to access surgical sites but also controls rebleeding following surgery. Time and again it has proven to be a highly effective management option which successfully bridges the conservative management and emergency laparotomy. In current scenario, in vascular injury, IR can obviate emergency laparotomy not only in hemodynamically stable but unstable patients as well, as evidenced by the recent literature. Ignorance and lack of acceptance have limited the utilization of IR significantly, which if practiced judiciously will provide expedient hemodynamic control as well as faster restoration to physiological status.