Der Unfallchirurg
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Hemorrhage after trauma in the area of the upper abdominal organs and the kidneys can represent a life-threatening situation. The primary treatment options are conservative or surgical treatment. Only in exceptional cases can endovascular treatment with an angiographic depiction of the active bleeding and, if necessary, intervention by means of embolization be used as an alternative.
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Approximately one third of all traumatic peripheral artery injuries affect the upper extremities, while two thirds involve the arteries of the lower extremities. Historically, these injuries were treated by open surgical repair. Nowadays, interventional treatment, such as embolization or stent grafting are increasingly used to treat peripheral artery injuries. ⋯ According to the promising clinical data, interventional treatment should be considered more often. Diagnostic algorithms need to be adapted accordingly.
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Percutaneous treatment of secondary thoracic and abdominal retention formations after blunt or penetrating trauma now represents a standard interventional radiological procedure. Various supportive imaging procedures are available, whereby computed tomography is mostly the treatment of choice due to the high diagnostic sensitivity. ⋯ After the study of this article you should have got to know and understand the indications for a minimally invasive approach, the possible techniques and necessary materials as well as the indications and contraindications.
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Pelvic arterial bleeding constitutes a potentially life-threatening event, which can be difficult to control with surgical procedures alone, especially in the case of ligamentous ruptures and a subsequently increased pelvic volume. ⋯ An interdisciplinary approach should be used in the indications for AE; which can be used as definitive treatment as well as in combination with surgical procedures. To improve the clinical outcome any delay between establishing the indications and the start of the intervention must be avoided.