J.Jpn. Surg. Soc.. 100(7): 435-442, 1999

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Feature topic

PROGRESS IN INTERVENTIONAL RADIOLOGY (IVR) IN EMERGENCY MEDICINE

IVR has attracted much attention in Japan over the past decade, and it is expected to be rapidly developed and widely used. Not surprisingly, IVR has already become essential in emergency medicine. This paper addresses IVR of the thoracic and abdominal areas and the pelvis in emergency medicine, in particular the recent IVR focus on the vasculature.
CO₂-DSA, which enables extravasation and easy detection of a arteriovenous or portal shunt, is also useful in the detection of bleeding in emergency situations.
In trauma cases, TAE, originating from an expanded concept of “damage control,” is commonly used to stop bleeding in order to perform surgical treatment or used during surgery. Occasionally the two applications are combined when appropriate. TAE is effective in controlling retroperitoneal bleeding resulting from pelvic fracture and parenchymatous organ injuries in the abdominal area.
Treatment with stent-grafts, originally used to treat true aneurysms, has recently been used for treatment of injuries of the aorta or arteries and for entry closure due to aortic dissection.
Furthermore, stent placement is expected to become an effective cure for organ ischemia, resulting from acute dissections.
Is addition, in order to cure repture of esophagus or gastric varices, such new treatments as TIPS and BRTO have increasingly been used, coupled with the conventional PTO treatment.
Continuous regional arterial infusion of protease inhibitor, in an attempt to cure severe acute pancreatitis, significantly reduced the infectious rate at the necrotic lesion, and its resulting motality rate. It is certain that great progress has been made in emergency medicine. We also should realize that it is desirable to be well versed even in new IVR.

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