Trans-arterial embolization is critical for managing traumatic peripheral artery hemorrhage, yet real-world data on embolic agent selection and physician practices are limited. This study evaluated practice patterns and embolic agent preferences among United States (U.S.) physicians performing peripheral artery embolization.

METHODS

A survey was administered via Sermo from 12/23/2024-1/3/2025, targeting U.S. physicians who had performed ≥10 trans-arterial angiographic embolization procedures for traumatic peripheral artery hemorrhage in the past year. Eligible participants were involved in procurement decisions for peripheral embolic agents at their institutions.

RESULTS

A total of 113 physicians completed the survey (58% response rate), comprising 46.9% interventional radiologists, 22.1% vascular surgeons, and 31.0% other specialists. Most performed trans-arterial embolization in academic medical centers (54.0%) and Level I trauma centers (52.2%). Coils were the most commonly used embolic agent, with 98.2% of respondents indicating their use, followed by gel-foam (79.6%), plugs (56.6%), particles (51.3%), glue (45.1%), dimethyl sulfoxide-based liquid embolics (34.5%), and conformable embolics (34.5%). Coils were used in 49.3% of cases, averaging 3.3 coils per procedure, varying by vascular territory: pelvis (4.5), spleen (4.0), liver (3.7), gastrointestinal tract (3.3), kidneys (3.0), lower extremity (3.0), chest/thoracic region (2.9), upper extremity (2.7), and pancreas (2.3). The average reported reintervention rate following coil embolization was 6.7%, requiring an additional 3.5 coils per case.

CONCLUSION

Coils are the predominant embolic agent for managing torso and extremity hemorrhage, with the number of coils varying by vascular territory. Further research is needed to examine clinical and physician-driven factors influencing embolic agent preferences and outcomes.