Chief, Vascular and Interventional Radiology San Antonio Military Medical Center, United States
Learning Objectives: 1. Define the scope and utility of expeditionary interventional radiology (EIR) in austere and deployed settings.
2. Highlight current limitations and opportunities in humanitarian assistance, disaster relief, and combat casualty care.
3. Describe the potential integration of EIR in future conflicts and the importance of continued development and research.
Background: EIR applies minimally invasive, image-guided techniques beyond conventional hospital infrastructure, extending IR’s reach into austere, resource-limited, and combat environments. Traditional IR’s reliance on static imaging platforms is now being challenged by innovations in portable hardware, modular procedural approaches, and rapid aerospace deployment platforms. Though successful examples of EIR exist—such as humanitarian efforts following natural disasters and battlefield trauma management—peer-reviewed literature remains limited, and interventional radiology is not yet formally integrated into forward military care roles or the established Roles 1-3 taxonomy {Ferrara; Snyder}.
Clinical Findings/Procedure Details: EIR has been successfully deployed aboard naval vessels like the USNS Mercy, as well as through mobile teams operating in low-resource environments. With portable ultrasound, mobile C-arms, and basic angiographic tools, IR procedures—ranging from embolization to drainage—have demonstrated safety and technical success {Ferrara}. In combat settings, IR has addressed junctional hemorrhage and provided minimally invasive options when traditional surgical resources were unavailable or delayed {Eastridge}. Damage Control IR and Conventional Emergency IR frameworks are being translated into field settings, leveraging early arterial access, rapid embolization with NBCA, and even intraoperative cone-beam CT. Modular platforms like Expeditionary Medical Support and aerospace vehicles designed by RAD-AID offer scalable EIR integration in both humanitarian and combat missions, enhancing mobility and response capacity {Snyder}.
Conclusion and/or Teaching Points: EIR provides a powerful, flexible toolkit for life- and limb-saving interventions in crisis settings. Its proven utility across a range of procedures in constrained environments suggests it should be a core component of future expeditionary medicine doctrine. As global conflicts evolve and humanitarian needs grow, formal inclusion of EIR within military medical frameworks—supported by targeted research and investment in mobility platforms—will be essential to modernize trauma care and improve global health equity {Ferrara; Snyder}.
