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Damage Control Interventional Radiology: The bridge between non-operative management and damage control surgery.损伤控制介入放射学:非手术治疗与损伤控制手术之间的桥梁。
CVIR Endovasc. 2024 Oct 3;7(1):71. doi: 10.1186/s42155-024-00485-z.
2
Damage control interventional radiology (DCIR) in prompt and rapid endovascular strategies in trauma occasions (PRESTO): A new paradigm.损伤控制介入放射学(DCIR)在创伤时刻的迅速和快速血管内策略(PRESTO)中:一种新的范例。
Diagn Interv Imaging. 2015 Jul-Aug;96(7-8):687-91. doi: 10.1016/j.diii.2015.06.001. Epub 2015 Jun 26.
3
The UK resuscitative endovascular balloon occlusion of the aorta in trauma patients with life-threatening torso haemorrhage: the (UK-REBOA) multicentre RCT.英国创伤患者伴危及生命的躯干出血行主动脉腔内球囊阻断复苏治疗的多中心 RCT(UK-REBOA)研究。
Health Technol Assess. 2024 Sep;28(54):1-122. doi: 10.3310/LTYV4082.
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Resuscitative endovascular balloon occlusion of the aorta for control of noncompressible truncal hemorrhage in the abdomen and pelvis.用于控制腹部和盆腔不可压迫性躯干出血的主动脉复苏性血管内球囊阻断术。
Am J Surg. 2016 Dec;212(6):1222-1230. doi: 10.1016/j.amjsurg.2016.09.027. Epub 2016 Sep 30.
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Resuscitative endovascular balloon occlusion of the aorta (REBOA): indications: advantages and challenges of implementation in traumatic non-compressible torso hemorrhage.主动脉复苏性血管内球囊阻断术(REBOA):适应症:在创伤性不可压缩性躯干出血中实施的优势与挑战
Trauma Surg Acute Care Open. 2019 Apr 15;4(1):e000262. doi: 10.1136/tsaco-2018-000262. eCollection 2019.
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Resuscitative endovascular balloon occlusion of the aorta (REBOA): a scoping review protocol concerning indications-advantages and challenges of implementation in traumatic non-compressible torso haemorrhage.复苏性主动脉球囊阻断术(REBOA):一项关于创伤性非压迫性躯干出血的适应证、优势和实施挑战的范围综述方案。
BMJ Open. 2019 Feb 19;9(2):e027572. doi: 10.1136/bmjopen-2018-027572.
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Outcomes of resuscitative endovascular balloon occlusion of the aorta (REBOA) utilization in trauma patients with and without traumatic brain injuries: A national analysis of the American College of Surgeons Trauma Quality Improvement Program data set.创伤患者中使用主动脉球囊阻断复苏术(REBOA)治疗有颅脑损伤和无颅脑损伤的结果:美国外科医师学会创伤质量改进计划数据集的全国性分析。
Surgery. 2021 Jul;170(1):284-290. doi: 10.1016/j.surg.2021.01.043. Epub 2021 Mar 4.
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The Implementation of a Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) Program at a Level 1 New England Trauma Center: Feasibility and Early Outcomes.在新英格兰 1 级创伤中心实施主动脉腔内球囊阻断复苏(REBOA)计划:可行性和早期结果。
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Resuscitative endovascular balloon occlusion of the aorta and resuscitative thoracotomy are associated with similar outcomes in traumatic cardiac arrest.主动脉球囊阻断复苏术和抢救性开胸术在创伤性心脏骤停中的效果相似。
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引用本文的文献

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Preoperative interventional radiology in penetrating posterior abdominal trauma with bowel injury: A case report.穿透性腹部后肠损伤的术前介入放射学:一例报告
Acute Med Surg. 2025 Jul 7;12(1):e70077. doi: 10.1002/ams2.70077. eCollection 2025 Jan-Dec.
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Hospital volume-outcome relationship in emergency trunk interventional radiology for trauma patients: a nationwide observational study in Japan.创伤患者急诊躯干介入放射学中的医院容量-结局关系:日本的一项全国性观察性研究。
Eur Radiol. 2025 Jun 6. doi: 10.1007/s00330-025-11743-6.
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Future directions in the treatment of pelvic fractures with abdominal organ injury: the potential of combined endovascular embolization and external fixation techniques.腹部脏器损伤合并骨盆骨折治疗的未来方向:血管内栓塞与外固定技术联合应用的潜力
Front Med (Lausanne). 2025 Mar 28;12:1565758. doi: 10.3389/fmed.2025.1565758. eCollection 2025.

本文引用的文献

1
Standardizing quality utilization of interventional radiology treatments of blunt splenic injury: SQUIRTS study.规范介入放射学治疗钝性脾损伤的质量利用:SQUIRTS 研究。
Injury. 2024 Sep;55(9):111707. doi: 10.1016/j.injury.2024.111707. Epub 2024 Jun 25.
2
Clinical Outcomes of Splenic Artery Embolization Versus Splenectomy in the Management of Hemodynamically Stable High-Grade Blunt Splenic Injuries: A National Analysis.脾动脉栓塞与脾切除术治疗血流动力学稳定的高级别钝性脾损伤的临床结局:全国性分析。
J Surg Res. 2024 Aug;300:221-230. doi: 10.1016/j.jss.2024.05.012. Epub 2024 Jun 1.
3
Use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for trauma and its performance in Japan over the past 18 years: a nationwide descriptive study.使用复苏性血管内球囊阻断主动脉术(REBOA)治疗创伤及其在过去 18 年中的日本应用表现:一项全国描述性研究。
World J Emerg Surg. 2024 May 31;19(1):19. doi: 10.1186/s13017-024-00548-5.
4
Damage Control Interventional Radiology in Liver Trauma: A Comprehensive Review.肝外伤中的损伤控制介入放射学:综述
J Pers Med. 2024 Mar 29;14(4):365. doi: 10.3390/jpm14040365.
5
Has the balloon really burst? Analysis of "the UK-REBOA randomized clinical trial".气球真的爆了吗?对“英国-REBOA 随机临床试验”的分析。
Am J Surg. 2024 Aug;234:62-67. doi: 10.1016/j.amjsurg.2024.04.016. Epub 2024 Apr 18.
6
Survival benefits of interventional radiology and surgical teams collaboration during primary trauma surveys: a single-centre retrospective cohort study.介入放射学和外科团队在初次创伤评估中的协作对生存获益的影响:一项单中心回顾性队列研究。
BMC Emerg Med. 2024 Apr 16;24(1):65. doi: 10.1186/s12873-024-00977-0.
7
Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial.创伤性出血性休克患者急诊经皮主动脉腔内球囊阻断复苏:英国 REBOA 随机临床试验。
JAMA. 2023 Nov 21;330(19):1862-1871. doi: 10.1001/jama.2023.20850.
8
Emergent vessel embolization for major traumatic and non-traumatic hemorrhage: Indications, tools and outcomes.紧急血管栓塞治疗严重创伤和非创伤性出血:适应证、工具和结果。
Semin Vasc Surg. 2023 Jun;36(2):283-299. doi: 10.1053/j.semvascsurg.2023.04.011. Epub 2023 May 1.
9
Usefulness of resuscitative endovascular balloon occlusion of the aorta compared to aortic cross-clamping in severely injured trauma patients: Analysis from the Japan Trauma Data Bank.在严重创伤患者中,与主动脉交叉钳夹相比,复苏性血管内主动脉球囊阻断术的有效性:来自日本创伤数据库的分析
Acute Med Surg. 2023 Mar 14;10(1):e830. doi: 10.1002/ams2.830. eCollection 2023 Jan-Dec.
10
Comparison of outcomes of proximal versus distal and combined splenic artery embolization in the management of blunt splenic injury: a report of 202 cases from a single trauma center.比较近端与远端及联合脾动脉栓塞治疗闭合性脾损伤的效果:单中心 202 例报告。
Surg Endosc. 2023 Jun;37(6):4689-4697. doi: 10.1007/s00464-023-09960-5. Epub 2023 Mar 8.

损伤控制介入放射学:非手术治疗与损伤控制手术之间的桥梁。

Damage Control Interventional Radiology: The bridge between non-operative management and damage control surgery.

作者信息

Ascenti Velio, Ierardi Anna Maria, Alfa-Wali Maryam, Lanza Carolina, Kashef Elika

机构信息

Postgraduate School of Radiology, University of Milan, Milan, IT, Italy.

Radiology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, IT, Italy.

出版信息

CVIR Endovasc. 2024 Oct 3;7(1):71. doi: 10.1186/s42155-024-00485-z.

DOI:10.1186/s42155-024-00485-z
PMID:39358662
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11447184/
Abstract

Traumatic injuries continue to be on the rise globally and with it, the role interventional radiology (IR) has also expanded in managing this patient cohort. The role of damage control surgery (DCS) has been well established in the trauma management pathway, however it is only recently that Damage Control IR (DCIR) has become increasingly utilized in managing the extremis trauma and emergency patient.Visceral artery embolizations (both temporary and permanent), temporary balloon occlusions including Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in iliac arteries and aorta respectively are amongst the treatment options now available for the trauma (and non-traumatic bleeding) patient.We review the literature for the role of DCS and utilization of IR in trauma, outcomes and the paradigm shift towards minimally invasive techniques. The focus of this paper is to highlight the importance of multi-disciplinary working and having established pathways to ensure timely treatment of trauma patients as well as careful patient selection.We show that outcomes are best when both surgical and IR are involved in patient care from the outset and that DCIR should not be defined as Non-Operative Management (NOM) as it currently is categorized as.

摘要

全球创伤性损伤持续增加,与此同时,介入放射学(IR)在管理这类患者群体方面的作用也得到了扩展。损伤控制手术(DCS)在创伤管理路径中的作用已得到充分确立,然而直到最近,损伤控制介入放射学(DCIR)才越来越多地用于管理危重伤和急诊患者。内脏动脉栓塞(包括临时和永久性栓塞)、临时球囊阻断(分别在髂动脉和主动脉进行的复苏性血管内球囊阻断主动脉术[REBOA])是目前创伤(和非创伤性出血)患者可用的治疗选择。我们回顾了关于DCS的作用以及IR在创伤中的应用、结果以及向微创技术的范式转变的文献。本文的重点是强调多学科协作以及建立确保及时治疗创伤患者和谨慎选择患者的途径的重要性。我们表明,从一开始手术和IR都参与患者护理时结果最佳,并且DCIR不应像目前分类那样被定义为非手术管理(NOM)。