Bauer Jason R, Ray Charles E
Radiology Resident, Department of Radiology, University of Colorado Health Sciences Center, Denver, Colorado.
Semin Intervent Radiol. 2004 Mar;21(1):11-22. doi: 10.1055/s-2004-831401.
Blunt and penetrating traumatic injuries may result in acute or subacute vascular injuries. These injuries to solid organs and extremity vessels are often managed in a conservative fashion. Acuity and hemodynamic compromise may dictate a surgical course; however, interventional techniques first popularized in the early 1970s now offer a wide range of solutions principally using transcatheter arterial embolization. There are a wide range of materials and clinical scenarios for which embolization is appropriate. Embolic agents such as coils, Gelfoam, and particles may be used individually or in combination to stop or control bleeding. In this way, embolotherapy may prove to be the safest and most effective form of therapy. The purpose of this article is to review the indications for embolization in the trauma patient and to provide guidelines regarding techniques and material selection.
钝性和穿透性创伤可能导致急性或亚急性血管损伤。这些对实体器官和四肢血管的损伤通常采用保守方式处理。损伤的严重程度和血流动力学不稳定可能决定采取手术治疗;然而,20世纪70年代初首次普及的介入技术现在主要通过经导管动脉栓塞提供了广泛的解决方案。有多种材料和临床情况适合进行栓塞治疗。诸如弹簧圈、明胶海绵和微粒等栓塞剂可单独使用或联合使用以止血或控制出血。通过这种方式,栓塞疗法可能被证明是最安全、最有效的治疗形式。本文的目的是回顾创伤患者栓塞治疗的适应证,并提供有关技术和材料选择的指导原则。