Interventional Care Is Life-Saving in Local Trauma Case

In 2011, Case Studies, Doherty, Gleason, Medsker, Newsletter, Volume 3 Issue 2 by Jennifer

When even minor accidents can cause major injuries, the presence of fast, multi-specialty trauma care saves lives. Interventional radiologists play an important role in local trauma team care by performing rapid, minimally invasive procedures, 24/7, for critical injuries of vital organs, pelvic hemorrhages, and peripheral vascular injuries. They collaborate with diagnostic radiologists, trauma surgeons, and emergency medicine specialists to improve patient outcomes in emergency cases.

Case in point: the victim of a minor car accident who was brought in recently to Stafford Hospital. John D. Gleason, MD, interventional radiologist with Virginia Interventional & Vascular Associates (VIVA), received an urgent call about the case from his colleague, Thomas T. Medsker, MD, a diagnostic radiologist with VIVA’s parent group, Radiologic Associates of Fredericksburg.

The patient was complaining of intense abdominal pain. Stafford Hospital’s emergency department had ordered CT scans, and an alert CT tech, suspecting an abnormality, contacted Dr. Medsker to make the case a high priority. Based on CT scans, Dr. Medsker diagnosed a large laceration in the right kidney and active bleeding in the   abdomen—both life-threatening conditions. He immediately notified the patient’s emergency department physician and Dr. Gleason so treatment could be coordinated swiftly.

The patient was quickly transferred to the Level II Trauma Center at Stafford’s sister facility, Mary Washington Hospital. There, Dr. Gleason performed an embolization that stopped the bleeding. Continuous internal medical images of the patient’s groin and abdomen, displayed on a nearby computer screen, helped Dr. Gleason guide the precise movements required for the interventional radiology procedure.

“In a procedure like this, you make a tiny incision in the skin, thread a small catheter from the patient’s groin to the renal artery, and place a metal coil in the [affected] artery to block the blood flow. The procedure is similar to tying off an artery, but without the major surgery or large incision,” Dr. Gleason explained.

Interventional radiology treatments offer other advantages over major surgery in appropriate cases. First, they are usually faster procedures for stopping massive bleeding. Second, interventional radiology treatments can sometimes spare vital organs. In the recent trauma case, for example, surgeons would have had to remove the injured kidney, since the lower third was destroyed. Using the embolization procedure, however, the interventional radiologist could preserve two-thirds of the injured kidney.

Interventional radiology procedures also help patients avoid the longer recuperation required after major surgery. In the recent trauma case, the patient was discharged four days after the accident.

Dr. Gleason (right) discusses case with Stephanie Finley, certified medical assistant.

“It’s not a daily occurrence, but our interventional radiologists perform embolizations and other procedures regularly for local trauma cases,” Dr. Gleason said. “Mary Washington Healthcare has a dedicated trauma surgery team [led by Lawrence Roberts, MD, director of trauma services], that knows what services we can provide and asks for our help in appropriate cases.”

 

 

 

 

Dr. Roberts noted, “The interventional radiologists’ commitment to performing procedures 24/7 for our trauma cases is remarkable, and we are fortunate to have the support of their team. Interventional Radiology responds identically to major Level I trauma centers in both capability and timing. It is truly a significant contribution in the care of the injured patient.”

 

For more information, contact John D. Gleason, MD, at gleason@rafimaging.com or
R. Donald Doherty Jr., MD, at doherty@rafimaging.com, leave a message for them at (540) 654-9118, or visit www.vivassociates.com.

 

Pictured above is Dr. Gleason of VIVA