Aparna Annam1, Shellie Josephs2, Thor Johnson3, Ann M Kulungowski4, Richard B Towbin5, Anne Marie Cahill6. 1. Division of Pediatric Radiology, Department of Radiology, University of Colorado, Children's Hospital Colorado, 13123 East 16th Avenue, Aurora, CO, 80045, USA. aparna.annam@childrenscolorado.org. 2. Department of Pediatric Radiology, Lucile Packard Children's Hospital, Stanford Medicine, Palo Alto, CA, USA. 3. Division of Vascular and Interventional Radiology, Medical University of South Carolina, Mount Pleasant, SC, USA. 4. Division of Pediatric Surgery, Department of Surgery, University of Colorado, Children's Hospital Colorado, Aurora, CO, USA. 5. Emeritus Radiologist-in-Chief at Phoenix Children's Hospital, Phoenix, USA. 6. Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Abstract
PURPOSE: While interventional radiologists occupy a critical role in adult trauma management, the role of interventionalist in pediatric trauma continues to evolve. The indications for transarterial embolization (TAE) are significantly different in pediatric patients in whom non-operative management (NOM) has a much more prominent role than in adults. Contrast extravasation on imaging may not require acute surgical or interventional management as it would in an adult. There are also areas in which pediatric interventional radiology is increasingly useful such as pelvic TAE in failed management, or splenic embolization to treat bleeding without the loss of splenic function inherent to surgical splenectomy. The rapid evolution of techniques and devices in pediatric patients is also changing what interventions are possible in pediatric trauma management which necessitates frequent reassessment of the guidelines and interventional radiology's role in caring for these patients. CONCLUSION: This review seeks to consolidate the recent literature to describe the evolving role of the interventional radiologist in pediatric trauma management.
PURPOSE: While interventional radiologists occupy a critical role in adult trauma management, the role of interventionalist in pediatric trauma continues to evolve. The indications for transarterial embolization (TAE) are significantly different in pediatric patients in whom non-operative management (NOM) has a much more prominent role than in adults. Contrast extravasation on imaging may not require acute surgical or interventional management as it would in an adult. There are also areas in which pediatric interventional radiology is increasingly useful such as pelvic TAE in failed management, or splenic embolization to treat bleeding without the loss of splenic function inherent to surgical splenectomy. The rapid evolution of techniques and devices in pediatric patients is also changing what interventions are possible in pediatric trauma management which necessitates frequent reassessment of the guidelines and interventional radiology's role in caring for these patients. CONCLUSION: This review seeks to consolidate the recent literature to describe the evolving role of the interventional radiologist in pediatric trauma management.
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