ESR Essentials: trauma team and the role of Interventional Radiology—practice recommendations by the Cardiovascular and Interventional Radiological Society of Europe

Trauma-related hemorrhage remains a leading cause of preventable death, requiring rapid diagnosis and timely intervention. Interventional Radiology (IR) plays a central role in the management of non-compressible bleeding, especially in solid organ injuries and pelvic trauma. This article outlines three key recommendations for integrating IR into trauma care. First, IR must be embedded in trauma teams with 24/7 availability at Level I trauma centers and structured access at Level II and III centers. Second, whole-body contrast-enhanced CT should be performed in hemodynamically stable or initially unstable but responsive patients, with immediate embolization when active extravasation or pseudoaneurysm is identified. Third, standardized embolization protocols and immediate access to essential materials-such as coils, plugs, liquid embolics, and stentgrafts-are critical for effective bleeding control. These recommendations are supported by current European guidelines and selected observational studies. To implement this guidance, trauma centers should develop IR-inclusive algorithms, define access pathways, and maintain trauma-ready IR inventories. Close collaboration between radiologists, surgeons, and emergency teams is essential to optimize patient outcomes and ensure timely intervention. KEY POINTS: Interventional radiologists should be fully integrated into trauma teams with 24/7 availability in Level I centers. Whole-body contrast-enhanced CT should be performed in stable trauma patients, followed by immediate embolization when active bleeding is detected. Standardized protocols and materials must be in place to ensure rapid and effective embolization in trauma-related hemorrhage.