title: Damage control interventional radiology (DCIR) in prompt and rapid endovascular strategies in trauma occasions (PRESTO): A new paradigm.
abstract: This article proposes an innovative concept of interventional radiology for hemodynamically unstable trauma patients. Damage control interventional radiology (DCIR) is an aggressive and time-conscious algorithm that prioritizes saving life of the hemorrhaging patient in extremis which conventional emergency interventional radiology (CEIR) cannot efficiently do. Briefly, DCIR aims to save life while CEIR aims to control bleeding with a constant concern to time-awareness. This article also presents the concept of "Prompt and Rapid Endovascular Strategies in Traumatic Occasions" (PRESTO) that entirely oversees and manages trauma patients from arrival to the trauma bay until initial completion of hemostasis with endovascular techniques. PRESTO's "Start soon and finish sooner" relies on the earlier activation of interventional radiology team but also emphasizes on a rapid completion of hemostasis in which DCIR has been specifically tailored. Both DCIR and PRESTO expand the role of IR and represent a paradigm shift in the realm of trauma care.
authors.affiliation: Departments of Emergency and Critical Care Medicine, Saint-Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, 216-8511 Kanagawa, Japan; Department of Radiology, National Hospital Organization Disaster Medical Center, Tachikawa, Tokyo, Japan. Electronic address: j3matsu@marianna-u.ac.jp.
authors.forename: J
authors.initials: J
authors.lastname: Matsumoto
authors.affiliation: Departments of Emergency and Critical Care Medicine, Saint-Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, 216-8511 Kanagawa, Japan. Electronic address: lohma036@gmail.com.
authors.forename: B D
authors.initials: BD
authors.lastname: Lohman
authors.affiliation: Department of Radiology, National Hospital Organization Disaster Medical Center, Tachikawa, Tokyo, Japan. Electronic address: koheim170303@gmail.com.
authors.forename: K
authors.initials: K
authors.lastname: Morimoto
authors.affiliation: Department of Radiology, National Hospital Organization Disaster Medical Center, Tachikawa, Tokyo, Japan. Electronic address: yoshiaki.ichinose@gmail.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Ichinose
authors.affiliation: Department of Radiology, Saint-Marianna University School of Medicine, Kawasaki, Kanagawa, Japan. Electronic address: taka-hat@ta2.so-net.ne.jp.
authors.forename: T
authors.initials: T
authors.lastname: Hattori
authors.affiliation: Departments of Emergency and Critical Care Medicine, Saint-Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, 216-8511 Kanagawa, Japan. Electronic address: y2taira@marianna-u.ac.jp.
authors.forename: Y
authors.initials: Y
authors.lastname: Taira
mesh_terms: D000465:Algorithms; D001925:Brain Damage, Chronic / Q000175:diagnosis / Q000517:prevention & control; D020202:Cerebral Hemorrhage, Traumatic / Q000175:diagnosis / Q000628:therapy*; D003299:Cooperative Behavior; D061345:Early Medical Intervention; D004621:Embolization, Therapeutic / Q000379:methods*; D004632:Emergency Medical Services; D006801:Humans; D033183:Interdisciplinary Communication; D011379:Prognosis; D014057:Tomography, X-Ray Computed
keywords: Damage control; Interventional radiology; Transcatheter arterial embolization; Trauma