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Interventional Radiologist Dr. Chris Ingraham discusses his approach to treating solid organ and pelvic trauma, including embolization technique and IR's role in workflow efficiency for better trauma care. --- CHECK OUT OUR SPONSOR Boston Scientific IOE https://www.bostonscientific.com/ioe --- SHOW NOTES In this episode, interventional radiologist Dr. Chris Ingraham and our host Dr. Michael Barraza discuss the role of IR in the trauma setting and approaches to embolization for trauma to the spleen, liver, kidneys, and pelvis. Dr. Ingraham outlines Harborview Medical Center’s workup of trauma patients and describes the collaboration between the emergency, trauma surgery, and interventional radiology departments. Although CT provides more comprehensive imaging, Dr. Ingraham says that taking a patient directly to an angiogram could address the trauma quicker and prevent more complications. He also speaks about empiric embolization, noting that extravasation can be intermittent and not visible on imaging. Overall, Dr. Ingraham recommends over-sizing coils, since patients are usually hypotensive and vasoconstrictive during active bleeding. Vessel diameter will eventually increase as patients are resuscitated. When embolizing the spleen, Dr. Ingraham emphasizes that the goal is to prevent the need for splenectomy, especially in young patients, because of its role in immunologic responses. He advocates for proximal embolization in order to decrease the blood flow into the spleen and allow for splenic lacerations to clot and heal. In liver embolization, Dr. Ingraham notes that there could be a laceration to the liver’s venous system, and embolization of the arterial system could reduce the dual blood supply of the liver. In these patients, there can be a higher risk of necrosis and biliary injury. Finally, we discuss follow up care with pulse exams and monitoring of hemodynamic stability. --- RESOURCES Balloons Up: Reduced Time to Angioembolization: https://www.ncbi.nlm.nih.gov/pmc/arti... SIR Trauma Guidelines, 2020: https://www.jvir.org/article/S1051-04... --- The BackTable Podcast is a resource for interventional radiologists, vascular surgeons, interventional cardiologists, and other interventional and endovascular specialists to learn tips, techniques, and the ins and outs of the devices in their cabinets. Get notified when new episodes drop! Subscribe to the BackTable Podcast on your go-to podcast platform, and follow us on your social media platform of choice for regular vascular and interventional updates. Apple ► https://podcasts.apple.com/us/podcast... Spotify ► https://open.spotify.com/show/0nP5QDe... YouTube ► https://www.youtube.com/c/BackTablePo... Twitter ► / _backtable LinkedIn ► / backtable Facebook ► / backtableir Instagram ► / _backtable Newsletter ► https://www.backtable.com/shows/vi/su...