Endovascular Embolization
Type
ReinforcementConfidence
78%
Created
Mar 27, 2026
Evidence
1 source
Rationale
The Wagner 2025 article is a systematic review and clinical practice guideline update directly addressing endovascular management of hemorrhage in multiply injured patients, which aligns closely with the section's focus on embolization indications. However, the article's relevance score is moderate (65/100) and the existing section is already well-supported by the WSES guideline Coccolini F, et al. The most appropriate integration is a brief reinforcing sentence appended to the existing WSES recommendation, rather than a structural rewrite. No existing content is contradicted, and the citation density of the original section (sparse, ~1 citation) is respected by adding only one new citation. The table structure, widget hint, and all existing citations are fully preserved.
Evidence
Content Changes
<!-- type: treatment --> **Table 16.3. Endovascular Embolization Agents and Applications** | **Agent Type** | **Examples** | **Best For** | | --- | --- | --- | | **Coils** | Pushable, detachable | Large vessel occlusion, pseudoaneurysms | | **Vascular Plugs** | Amplatzer | Rapid large vessel occlusion | | **Gelfoam** | Absorbable gelatin | Temporary hemostasis, small vessels | | **Liquid Embolics** | NBCA, Onyx | Distal vessels, AV fistulae | **Indications**: - Pelvic hemorrhage (pelvic ring fractures) [@coccolini2017-wses] - Solid-organ trauma (spleen, liver, kidney) - Junctional or retroperitoneal bleeding **WSES Recommendation**: Angioembolization as first-line for uncontrolled pelvic bleeding where available, with preperitoneal pelvic packing as complementary when angiography is delayed [@coccolini2017-wses]. A 2025 systematic review and clinical practice guideline update further supports endovascular management of hemorrhage and vascular lesions in patients with multiple and/or severe injuries [@wagner2025-h].