title: [Vascular interventional radiology: a fundamental procedure for the management of paediatric trauma].
abstract: BACKGROUND
  The management of active bleeding with haemodinamic lability in the paediatric trauma patient is difficult and generally leads to damage control surgery. Vascular Interventional Radiology (VIR) techniques are useful for the diagnosis as for the definitive treatment.
  
  
  OBJECTIVE
  The aim of our study was to describe our experience and evaluate effectiveness of VIR in the management of the paediatric trauma patient with active bleeding signs.
  
  
  METHODS
  Retrospective analysis (2003-2014) of politraumatic patients who showed contrast blush on computed tomography and then treated by VIR techniques.
  
  
  RESULTS
  In the reported study period 16 patients underwent VIR procedures. Medium age was 13 years (5-17). The most frequent lesion mechanism was traffic accident (8 out of 17) and 93,75% were blunt traumas. Findings on initial Computed Tomography were 12 contrast blushes and 2 absences of arterial flow. In 2 cases the contrast blush appeared 48 hours after the accident. Arteriography allowed us to localize the bleeding vessels in all the cases, performing selective or supraselective renal (7), pelvic (5), hepatic (3), splenic (1) and intercostal (1) embolization. One patient required an endoprothesis for renal revascularization. Two cases needed additional surgical procedures (2 nephrectomies) because of complete section of the renal artery (1) and disruption of the ureteropelvic junction (1). One case required hemofiltration in relation to rhabdomyolysis.
  
  
  CONCLUSIONS
  In our experience VIR is a valuable diagnostic and therapeutic procedure for the management of paediatric trauma patients, with high effectiveness and a low complication rate.
authors.affiliation: Servicio de Cirugía Pediátrica. Programa de Trauma Pediátrico. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: E
authors.initials: E
authors.lastname: Bordón Cabrera
authors.affiliation: Servicio de Cirugía Pediátrica. Programa de Trauma Pediátrico. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: A
authors.initials: A
authors.lastname: Laín
authors.affiliation: Servicio de Cirugía Pediátrica. Programa de Trauma Pediátrico. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: R
authors.initials: R
authors.lastname: Gander
authors.affiliation: Servicio de Radiología Intervencionista. Programa de Trauma Pediátrico. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: M
authors.initials: M
authors.lastname: Pérez Lafuente
authors.affiliation: Servicio de Radiología Intervencionista. Programa de Trauma Pediátrico. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: I
authors.initials: I
authors.lastname: Díez Miranda
authors.affiliation: Servicio de Traumatología y Ortopedia Pediátrica. Programa de Trauma Pediátrico. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: C G
authors.initials: CG
authors.lastname: Fontecha
authors.affiliation: Servicio de Cuidados Intensivos Pediátricos. Programa de Trauma Pediátrico. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: L
authors.initials: L
authors.lastname: Seidler
authors.affiliation: Servicio de Radiología Pediátrica. Programa de Trauma Pediátrico. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: I
authors.initials: I
authors.lastname: Delgado
authors.affiliation: Servicio de Urgencias Pediátricas. Programa de Trauma Pediátrico. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: S
authors.initials: S
authors.lastname: Cañadas Palazón
authors.affiliation: Servicio de Cirugía Pediátrica. Programa de Trauma Pediátrico. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: J
authors.initials: J
authors.lastname: Lloret
mesh_terms: D000293:Adolescent; D000792:Angiography; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic / Q000379:methods; D006470:Hemorrhage / Q000000981:diagnostic imaging*; D006801:Humans; D009104:Multiple Trauma / Q000000981:diagnostic imaging*; D009392:Nephrectomy; D015642:Radiology, Interventional / Q000379:methods*; D012077:Renal Artery / Q000293:injuries / Q000601:surgery; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*
keywords: Multiple trauma paediatric; Paediatrics abdominal injuries; Vascular Interventional Radiology