Ascenti Velio, Ierardi Anna Maria, Alfa-Wali Maryam, Lanza Carolina, Kashef Elika
Postgraduate School of Radiology, University of Milan, Milan, IT, Italy.
Radiology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, IT, Italy.
CVIR Endovasc. 2024 Oct 3;7(1):71. doi: 10.1186/s42155-024-00485-z.
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.
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)。