Nonoperative Management of Unstable Patients with Solid Organ Injury: An Incompletely Mapped Frontier

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Embolization of traumatic arterial injury spawned a frontier in interventional radiology (IR) nearly 50 years ago. In 1972, Stanley Baum and colleagues (1) described embolizing hemodynamically unstable patients with pelvic fractures and arterial injury using an autologous clot. In the following decade, successful embolization of solid organs such as the spleen was described by interventional radiologists in patients in shock (2). Since then, endovascular therapy has evolved into a mainstay of nonoperative management (NOM) for patients with solid organ injury who are hemodynamically stable and lack an additional indication for abdominal surgery.