INTERVENTIONAL RADIOLOGY IN THE TRAUMA PATIENT

The role of radiology in the emergency treatment of the trauma patient continues to grow as it yields increasingly accurate diagnostic information and above all offers the possibility of endovascular and percutaneous interventions. Helical CT combined with angiography provide optimal diagnostic information in the trauma patient. CT is the first method of choice for assessment of parenchymatous organs to disclose any haematomas, urinomas or bilomas, while angiography is the gold standard for accurate localization and identification of the vessels responsible for haemorrhage, and to establish diagnosis of vascular injury (vascular dehiscence, dissection, total or partial rupture, pseudo-aneurysm, post-traumatic thrombosis). These findings together with clinical evaluation are essential to establish the type and optimal timing of the therapeutic strategy: immediate surgery or immediate definitive interventional radiology or radiological intervention prior to elective surgery. Three types of radiological intervention can be used to treat trauma patients: vessel occlusion using balloon catheters, embolization, and placement of a stent-graft (or covered stent).