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Radiologic damage control: evaluation of a combined CT and angiography suite with a pivoting table
X Kos1, J M Fanchamps, G Trotteur
1Department of Medical Imaging, University Hospital Sart Tilman, B-4000 Liège, Belgium.
Purpose:
To evaluate retrospectively the integrated diagnostic and therapeutic management of severely polytraumatized patients using a combined computed tomography (CT) and angiography suite with a single pivoting table.
Methods:
Eleven patients, aged 16-74 years (median 30 years), were managed with spiral CT and angiography without patient transfer. Four patients were unstable, seven had received blood transfusions (2-18 units) and six were intubated. In 10 patients in whom active bleeding was demonstrated (splenic 5, hepatic 2, renal 2, left inferior epigastric artery 1), hemostatic embolization was obtained.
Results:
Total procedure time did not exceed 80 min. Immediate hemostasis was achieved in all patients. Recurrent bleeding from the liver required additional embolization in one patient. Median length of stay in the intensive care unit was 4 days and median hospital stay was 27 days. All patients survived without significant sequelae.
Conclusion:
The use of a combined CT-angiography suite enables rapid diagnostic investigation and hemostatic embolization in actively bleeding trauma patients.