Indications and Use of Angiography and Angioembolization in Pediatric Trauma

To critically evaluate the recent literature regarding the use of angiography and angioembolization (AE) in the management of pediatric trauma patients, and to provide expert opinion regarding the indications and usage of these modalities clinically.

• Utilization of angiography and AE remain uncommon in the management of pediatric trauma patients, but may be important adjuncts in a highly select patient population [1].

• Compared to adult trauma centers, pediatric trauma centers employ these modalities less frequently, but demonstrate higher rates of splenic salvage [2, 3].

• AE should be considered only after appropriate resuscitation with blood products has occurred [4].

The role of angiography and AE remains incompletely defined when it comes to implementation in pediatric trauma patients. The literature demonstrates that the pediatric population may differ significantly from the adult population when it comes to the utility of angiography and AE for management of traumatic injuries. While it remains an important adjunctive therapy is select patients, studies demonstrate the importance of blood product resuscitation as first line in the management of bleeding pediatric trauma patients.