Semin intervent Radiol 2009; 26(3): 207-214
DOI: 10.1055/s-0029-1225669
© Thieme Medical Publishers

Visceral Arteriography in Trauma

A. Rao Chimpiri1 , Balasubramani Natarajan1
  • 1Department of radiology, Oklahoma University of Health Sciences, Oklahoma City, Oklahoma
Further Information

Publication History

Publication Date:
12 August 2009 (online)


The nonoperative management including endovascular treatment of traumatic injuries to most abdominal solid viscera is increasingly gaining acceptance as treatment of choice in a select group of patients. The indications, techniques, and principles of endovascular management of hepatic, splenic, and renal injuries are discussed in this review.


  • 1 Hagiwara A, Murata A, Matsuda T, Matsuda H, Shimazaki S. The efficacy and limitations of transarterial embolization for severe hepatic injury.  J Trauma. 2002;  52(6) 1091-1096
  • 2 Hagiwara A, Yukioka T, Ohta S et al.. Nonsurgical management of patients with blunt hepatic injury: efficacy of transcatheter arterial embolization.  AJR Am J Roentgenol. 1997;  169(4) 1151-1156
  • 3 Schwartz R A, Teitelbaum G P, Katz M D, Pentecost M J. Effectiveness of transcatheter embolization in the control of hepatic vascular injuries.  J Vasc Interv Radiol. 1993;  4(3) 359-365
  • 4 Hidalgo F, Narváez J A, Reñé M, Domínguez J, Sancho C, Montanyà X. Treatment of hemobilia with selective hepatic artery embolization.  J Vasc Interv Radiol. 1995;  6(5) 793-798
  • 5 Goffette P P, Laterre P F. Traumatic injuries: imaging and intervention in post-traumatic complications (delayed intervention).  Eur Radiol. 2002;  12(5) 994-1021
  • 6 Croce M A, Fabian T C, Menke P G et al.. Nonoperative management of blunt hepatic trauma is the treatment of choice for hemodynamically stable patients. Results of a prospective trial.  Ann Surg. 1995;  221(6) 744-753, discussion 753–755
  • 7 Hagiwara A, Yukioka T, Shimazaki S, Megawa T, Matuda H. Delayed hemorrhage following transcatheter arterial embolization for blunt hepatic injury.  Cardiovasc Intervent Radiol. 1993;  16(6) 380-383
  • 8 Gow K W, Murphy III J J, Blair G K, Stringer D A, Culham J A, Fraser G C. Splanchnic artery pseudo-aneurysms secondary to blunt abdominal trauma in children.  J Pediatr Surg. 1996;  31(6) 812-815
  • 9 Sidhu M K, Shaw D WW, Daly C P, Waldhausen J H, Coldwell D. Post-traumatic hepatic pseudoaneurysms in children.  Pediatr Radiol. 1999;  29(1) 46-52
  • 10 Owings J T, Lengle S J. Combined hepatic abscess and arterial pseudoaneurysms from blunt trauma: a case report and management strategy.  J Trauma. 1995;  38(4) 634-638
  • 11 Tzeng W S, Wu R H, Chang J M et al.. Transcatheter arterial embolization for hemorrhage caused by injury of the hepatic artery.  J Gastroenterol Hepatol. 2005;  20(7) 1062-1068
  • 12 Teitelbaum G P, Reed R A, Larsen D et al.. Microcatheter embolization of non-neurologic traumatic vascular lesions.  J Vasc Interv Radiol. 1993;  4(1) 149-154
  • 13 Ohtsuka Y, Iwasaki K, Okazumi S et al.. Management of blunt hepatic injury in children: usefulness of emergency transcatheter arterial embolization.  Pediatr Surg Int. 2003;  19(1-2) 29-34
  • 14 Hasegawa S, Moriwaki Y, Uchida K, Kosuge T, Yamamoto T, Sugiyama M. Biliary leakage due to a rapidly growing post-traumatic hepatic artery pseudoaneurysm: a case report.  Hepatogastroenterology. 2004;  51(56) 434-435
  • 15 Huang X Q, Huang Z Q, Duan W D, Zhou N X, Feng Y Q. Severe biliary complications after hepatic artery embolization.  World J Gastroenterol. 2002;  8(1) 119-123
  • 16 Wolf H M, Eibl M M, Georgi E et al.. Long-term decrease of CD4+CD45RA+ T cells and impaired primary immune response after post-traumatic splenectomy.  Br J Haematol. 1999;  107(1) 55-68
  • 17 Sclafani S J, Shaftan G W, Scalea T M et al.. Nonoperative salvage of computed tomography-diagnosed splenic injuries: utilization of angiography for triage and embolization for hemostasis.  J Trauma. 1995;  39(5) 818-825, discussion 826–827
  • 18 Davis K A, Fabian T C, Croce M A et al.. Improved success in nonoperative management of blunt splenic injuries: embolization of splenic artery pseudoaneurysms.  J Trauma. 1998;  44(6) 1008-1013, discussion 1013–1015
  • 19 Haan J M, Biffl W, Knudson M M Western Trauma Association Multi-Institutional Trials Committee et al. Splenic embolization revisited: a multicenter review.  J Trauma. 2004;  56(3) 542-547
  • 20 Schwalke M A, Crowley J P, Spencer P, Metzger J, Kawan M, Burchard K W. Splenic artery ligation for splenic salvage: clinical experience and immune function.  J Trauma. 1991;  31(3) 385-388
  • 21 Hagiwara A, Sakaki S, Goto H et al.. The role of interventional radiology in the management of blunt renal injury: a practical protocol.  J Trauma. 2001;  51(3) 526-531
  • 22 Eastham J A, Wilson T G, Ahlering T E. Urological evaluation and management of renal-proximity stab wounds.  J Urol. 1993;  150(6) 1771-1773
  • 23 Uflacker R, Paolini R M, Lima S. Management of traumatic hematuria by selective renal artery embolization.  J Urol. 1984;  132(4) 662-667
  • 24 Heyns C F, Van Vollenhoven P. Selective surgical management of renal stab wounds.  Br J Urol. 1992;  69(4) 351-357
  • 25 Bruce L M, Croce M A, Santaniello J M, Miller P R, Lyden S P, Fabian T C. Blunt renal artery injury: incidence, diagnosis, and management.  Am Surg. 2001;  67(6) 550-554, discussion 555–556
  • 26 Clark D E, Georgitis J W, Ray F S. Renal arterial injuries caused by blunt trauma.  Surgery. 1981;  90(1) 87-96

A. Rao ChimpiriF.R.C.R. 

Assistant Professor of Radiology

Oklahoma University of Health Sciences, Oklahoma City, OK 73126-0901