Impact of Computed Tomography-to-Angiography Interval Time on Outcomes of Transarterial Embolization in Post-Traumatic Bleeding: A Retrospective Observational Study.

Background/Objectives: Transarterial embolization nowadays has a pivotal role in non-operative management strategies of post-traumatic bleeding. Timely control of hemorrhage is critical in trauma care; however, the impact of procedural timing remains underexplored. This single-center study, conducted at a Level II trauma center with 24/7 interventional radiology coverage, evaluated the influence of interval time on embolization outcomes in post-traumatic bleeding patients. Methods: In this retrospective study, 182 trauma patients who underwent embolization between June 2020 and June 2025 were analyzed. Patients were stratified by CT-to-angiography interval time (≤1 h [early, n = 46] and >1 h [delayed, n = 136]). Hemodynamic parameters, laboratory values, transfusion needs, and outcomes were compared and adjusted for baseline differences. Results: Early group patients showed more severe baseline physiology, including hypotension, higher lactates, and lower hemoglobin. No significant differences were found in mortality (2.9% vs. 2.5%), hospital stay (18.7 ± 26.1 vs. 18.1 ± 22.2 days), or transfusion requirements. Embolizations within one hour from CT were associated with significant lactate reduction at 24 h in univariate analysis (p = 0.039), but this was not confirmed in multivariate analysis. Re-embolization (8.7% vs. 1.5%, p = 0.036) and surgical rescue (13.0% vs. 3.7%, p = 0.033) rates were more frequent in the early group. Conclusions: Early embolization improves metabolic parameters in post-traumatic bleeding, especially in patients with greater baseline severity of injuries. These findings support prioritization of early embolization and structured interventional radiology networks for timely procedures. A personalized approach according to baseline injury is required.