THE ROLE OF INTERVENTIONAL RADIOLOGY IN THE MANAGEMENT OF HEMODYNAMICALLY COMPROMISED PATIENTS: A META-ANALYSIS
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Keywords
interventional radiology, hemodynamic instability, trauma, gastrointestinal bleeding, neonates, dialysis, endovascular intervention, angioembolization, critical care, minimally invasive
Abstract
Hemodynamic instability represents a life-threatening condition commonly encountered in emergency and critical care settings. While conventional treatments include surgical intervention and pharmacological support, interventional radiology (IR) has emerged as a vital, minimally invasive option for managing patients with compromised hemodynamics. This meta-analysis systematically evaluates the role of IR across various clinical contexts, including trauma, gastrointestinal bleeding, dialysis-related complications, and neonatal care. A comprehensive literature search was conducted across databases including PubMed, Embase, Scopus, and Google Scholar for studies published between 2013 and 2022. Nine studies met the inclusion criteria, encompassing both adult and pediatric populations. Pooled results showed that early IR interventions—particularly angiographic embolization, endovascular stenting, and catheter-directed therapies—were significantly associated with improved hemodynamic stability, reduced mortality, and decreased reliance on surgical procedures. Subgroup analysis highlighted the efficacy of IR in trauma and gastrointestinal bleeding cases, with particular benefits noted in early implementation. In neonatal populations, echo-guided cardiovascular support improved survival and individualized care. Also, IR-linked strategies improved outcomes for dialysis related hypotension. Procedural complications such as dermatologic issues warrant post-intervention vigilance. While these risks exist, the overall evidence strongly supports the use of IR as a cornerstone to the multidisciplinary approach to the hemodynamically unstable patients. It reflects the potential for IR to play a transformative role in modern acute care, rapidly stabilizing critical patients whilst keeping procedures as minimally invasive as possible. Future studies will focus on further optimizing IR protocols and investigate the use of real time predictive technologies for early identification and intervention in hemodynamic compromise.
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Munesh Kumar Nenwani
Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Pakistan.
Hamza Ahmed Qureshi
Mercer University, USA.
Rabia Amir
Jinnah Sindh Medical University, Karachi, Pakistan.
Vikram Singh Rajput
Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Pakistan / Junior Clinical Fellow at Geriatric Medicine Barnet Hospital Toyal Free London, NHS Foundation Trust.
FNU Kajol
Bahria University Medical and Dental College, Karachi, Pakistan.
Arzoo Pir Mohammad
Faculty of Medicine, Kabul University of Medical Sciences, Kabul, Afghanistan.
Mahesh Kumar
Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Pakistan.
Muhammad Salman
Liaquat University of Medical & Health Science Jamshoro, Pakistan / Resident Medical Officer (RMO) In Royal Institute of Medicine & Surgery Hospital (RIMS) Karachi, Pakistan
Muhammad Shoaib Khan
House Physician, Latin American School of Medicine, Cuba / Wyckoff Heights Medical Center, Brooklyn, New York, USA.
Muhammad Subhan
Department of Medicine (Gastroenterology), Jinnah Hospital Lahore / Allama Iqbal Medical College, Lahore, Pakistan.