대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제84권4호
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  • Pages.784-791
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  • 2023
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  • 1738-2637(pISSN)
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  • 2951-0805(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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외상센터에서의 인터벤션 영상의학 의사의 역할

Role of Interventional Radiologists in Trauma Centers

  • 김정호 (가천대학교 의과대학 길병원 영상의학과)
  • Jeong Ho Kim (Department of Radiology, Gil Medical Center, Gachon University College of Medicine)
  • 투고 : 2023.04.02
  • 심사 : 2023.06.30
  • 발행 : 2023.07.01
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⟨ 이전 논문 다음 논문 ⟩

초록

국내의 각종 통계에 따르면 외상센터는 외상 환자 치료에 중심적이며 확고한 역할을 담당하고 있는 것으로 나타났다. 외상센터에서 인터벤션 영상의학자의 역할은 출혈이 멈추도록 하는 것이다. 기본적인 색전술이 치료의 근간을 이루지만 스텐트 그래프트 설치술 등이 사용되기도 한다. 전통적인 응급인터벤션시술이 사용되어 왔으나 외상 환자에게는 짧은 시간 내에 효율적으로 출혈을 막는 것이 필수적이다. 따라서, 최근 부각되고 있는 손상통제인터벤션영상의학의 개념을 정확히 인지하고 실행하는 것이 예방 가능 외상 사망률을 낮추는데 매우 중요하다.

Based on statistics available in Korea, trauma centers play a critical role in treatment of patients with trauma. Interventional radiologists in trauma centers perform various procedures, including embolization, which constitutes the basic treatment for control of hemorrhage, although interventions such as stent graft insertion may also be used. Although emergency interventional procedures have been used conventionally, rapid and effective hemorrhage control is important in patients with trauma. Therefore, it is important to accurately understand and implement the concept of damage control interventional radiology, which has gained attention in recent times, to reduce preventable trauma-induced mortality rates.

키워드

참고문헌

  1. The Korean Society of Traumatology. Textbook of trauma. Introduction. 1st ed. Seoul: Bummun Education 2018:3-5
  2. Ministry of Health and Welfare. 2022 Korean trauma data bank annual statistics (number 4). Available at. https://www.e-gen.or.kr/nemc/statistics_annual_report.do?brdclscd=04. Published November 25, 2022. Accessed March 1, 2023
  3. Ministry of Health and Welfare. The nationwide 'preventable trauma mortality rate' has significantly improved from 30.5% to 19.9%, indicating a substantial reduction. Available at. https://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=351836. Published December 10, 2019. Accessed March 1, 2023
  4. Lee MA, Yu B, Lee J, Park JJ, Lee GJ, Choi KK, et al. Effects of the establishment of a trauma center and a new protocol on patients with hemodynamically unstable pelvic fractures at a single institution in Korea. Eur J Trauma Emerg Surg 2019;45:273-279 https://doi.org/10.1007/s00068-017-0899-y
  5. Trunkey DD. Trauma. Sci Am 1983;249:28-35 https://doi.org/10.1038/scientificamerican0883-28
  6. Zealley IA, Chakraverty S. The role of interventional radiology in trauma. BMJ 2010;340:c497
  7. The Korean Society of Traumatology. Textbook of trauma. Interventional radiology: diangostic and therapeutic role. 1st ed. Seoul: Bummun Education 2018:113-120
  8. Wolf R, Smolinski-Zhao S. Delayed and chronic sequelae of trauma and the role of the interventional radiologist. Semin Intervent Radiol 2021;38:131-138 https://doi.org/10.1055/s-0041-1726003
  9. Ierardi AM, Duka E, Lucchina N, Floridi C, De Martino A, Donat D, et al. The role of interventional radiology in abdominopelvic trauma. Br J Radiol 2016;89:20150866
  10. Eassa W, El-Ghar MA, Jednak R, El-Sherbiny M. Nonoperative management of grade 5 renal injury in children: does it have a place? Eur Urol 2010;57:154-161 https://doi.org/10.1016/j.eururo.2009.02.001
  11. van der Wilden GM, Velmahos GC, Joseph DK, Jacobs L, Debusk MG, Adams CA, et al. Successful nonoperative management of the most severe blunt renal injuries: a multicenter study of the research consortium of new England centers for trauma. JAMA Surg 2013;148:924-931 https://doi.org/10.1001/jamasurg.2013.2747
  12. Monnin V, Sengel C, Thony F, Bricault I, Voirin D, Letoublon C, et al. Place of arterial embolization in severe blunt hepatic trauma: a multidisciplinary approach. Cardiovasc Intervent Radiol 2008;31:875-882 https://doi.org/10.1007/s00270-007-9277-1
  13. Lee R, Jeon CH, Kim CW, Kwon H, Kim JH, Kim H, et al. Clinical results of distal embolization in grade V splenic injury: four-year experience from a single regional trauma center. J Vasc Interv Radiol 2020;31:1570-1577.E2 https://doi.org/10.1016/j.jvir.2020.01.029
  14. Kwon H, Bae M, Jeon CH, Hwangbo L, Lee CM, Kim CW. Volume preservation of a shattered kidney after blunt trauma by superselective renal artery embolization. Diagn Interv Radiol 2022;28:72-78 https://doi.org/10.5152/dir.2021.21711
  15. Kristinsson SY, Gridley G, Hoover RN, Check D, Landgren O. Long-term risks after splenectomy among 8,149 cancer-free American veterans: a cohort study with up to 27 years follow-up. Haematologica 2014;99:392-398 https://doi.org/10.3324/haematol.2013.092460
  16. Sofocleous CT, Hinrichs C, Hubbi B, Brountzos E, Kaul S, Kannarkat G, et al. Angiographic findings and embolotherapy in renal arterial trauma. Cardiovasc Intervent Radiol 2005;28:39-47 https://doi.org/10.1007/s00270-004-0042-4
  17. Abu-Gazala M, Shussman N, Abu-Gazala S, Elazary R, Bala M, Rozenberg S, et al. Endovascular management of blunt renal artery trauma. Isr Med Assoc J 2013;15:210-215
  18. Lopera JE, Suri R, Kroma G, Gadani S, Dolmatch B. Traumatic occlusion and dissection of the main renal artery: endovascular treatment. J Vasc Interv Radiol 2011;22:1570-1574 https://doi.org/10.1016/j.jvir.2011.08.002
  19. Papakostidis C, Kanakaris N, Dimitriou R, Giannoudis PV. The role of arterial embolization in controlling pelvic fracture haemorrhage: a systematic review of the literature. Eur J Radiol 2012;81:897-904 https://doi.org/10.1016/j.ejrad.2011.02.049
  20. Franco DF, Zangan SM. Interventional radiology in pelvic trauma. Semin Intervent Radiol 2020;37:44-54 https://doi.org/10.1055/s-0039-3401839
  21. Kim H, Jeon CH, Kim JH, Sun HW, Ryu D, Lee KH, et al. Transarterial embolisation is associated with improved survival in patients with pelvic fracture: propensity score matching analyses. Eur J Trauma Emerg Surg 2021;47:1661-1669 https://doi.org/10.1007/s00068-020-01497-9
  22. Liu JL, Li JY, Jiang P, Jia W, Tian X, Cheng ZY, et al. Literature review of peripheral vascular trauma: is the era of intervention coming? Chin J Traumatol 2020;23:5-9 https://doi.org/10.1016/j.cjtee.2019.11.003
  23. Matsumoto J, Lohman BD, Morimoto K, Ichinose Y, Hattori T, Taira Y. Damage control interventional radiology (DCIR) in prompt and rapid endovascular strategies in trauma occasions (PRESTO): a new paradigm. Diagn Interv Imaging 2015;96:687-691 https://doi.org/10.1016/j.diii.2015.06.001
  24. Kwon H, Kim CW. Introduction and trauma intervention of chest and great vessels. In Korean Society of Interventional Radiology, ed. Internventional radiology. 3rd ed. Seoul: Ilchokak 2022:621-626
  25. Padia SA, Ingraham CR, Moriarty JM, Wilkins LR, Bream PR Jr, Tam AL, et al. Society of interventional radiology position statement on endovascular intervention for trauma. J Vasc Interv Radiol 2020;31:363-369.E2 https://doi.org/10.1016/j.jvir.2019.11.012