Background

The role of IR is to stop haemorrhage as quickly as possible with minimal interference to the patient’s physiology. It is as much a form of damage control as surgical packing or pressing on a bleeding artery.

Referral and activation times

Where active extravasation is seen, the on-call interventional radiologist should be informed immediately along with the TTL. IR teams should be in place within 60 minutes of the patient’s admission or 30 minutes of referral. Early warning/activation must be considered in select patients.

Indications for intervention

Organ Exclusions (surgery indicted) Intervention
Kidney – active arterial bleeding Multiple other bleeding sites or other indication for surgery Embolisation or stent graft
Spleen – active arterial bleeding or pseudoaneurysm Multiple other bleeding sites or other indication for surgery Focal or proximal embolisation
Liver – active arterial bleeding or pseudoaneurysm or failed surgery Multiple other bleeding sites or other indication for surgery Focal or non selective embolisation if portal vein patent
Pelvis - active arterial bleeding, pseudoaneurysm or cut-off Multiple other bleeding sites or other indication for surgery Focal embolisation
Thoracic aorta distal to left subclavian artery Ascending or arch involving great vessels Stent graft

Editorial Information

Last reviewed: 01/09/2021

Next review date: 01/09/2024

Version: 1.0