Goslings J C, van Delden O M
Trauma-unit, Afd. Chirurgie, Academisch Medisch Centrum/Universiteit van Amsterdam, Meibergdreef 9, 1005 AZ Amsterdam.
Ned Tijdschr Geneeskd. 2007 Feb 10;151(6):345-52.
Angiography and embolisation are being increasingly used to control bleeding following abdominal and pelvic trauma. CT is a useful tool to select patients for such intervention-radiological angiography. The application ofangiography and embolisation requires a specific local infrastructure, logistics and expertise on the part of the radiologist, traumatologist and anaesthetist. The main indications for angiography and embolisation are: contrast blush on the CT scan and clinical signs of ongoing bleeding; they are also indicated as an adjunct to damage control procedures. Angiography and embolisation are successful in about 90% of the patients; complications occur in < 10% of the patients. An accurate estimate of the patient's physical condition, a correct assessment of the severity of the injury, and a multidisciplinary approach are important factors in the success of embolisation therapy.