Selective Use of Endovascular Techniques in the Damage Control Setting
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In severely injured trauma patients the hemorrhage control should occur as soon as possible, with a time-consciousness multidisciplinary protocol to reduce coagulopathies and secondary compartment syndrome risks. The damage control interventional radiology (DCIR) is an aggressive and time-conscious algorithm that prioritizes lifesaving maneuvers. As in damage control surgery, the DCIR could be a multistep strategy to maintain the patient alive, sometimes controlling but not definitively repairing the injury. It’s a teamwork effort in a very time-restricted procedure, and it’s crucial that all decisions should be shared with the trauma team. The choice of materials, embolic agent, and the operator expertise are critical to ultimate success. When severely injured patients are hemodynamically unstable, the DCIR suggest abandoning any time-consuming procedure in favor of another to save the patients’ life. The use of a hybrid trauma room containing an angiography suite/operating room is paramount for DCIR.
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