Guidelines and Consensus
Applied
Type
AdditionConfidence
72%
Created
Mar 28, 2026
Evidence
1 source
Rationale
The Wagner 2025 article is a systematic review and clinical practice guideline update directly relevant to the Guidelines and Consensus section. It updates the evidence base for endovascular management of hemorrhage in polytrauma patients, complementing the existing ACS-COT/NAEMSP, WSES, and EVTM entries. A new guideline entry has been added in the same format as existing entries, preserving section structure and citation density. The article was flagged rather than approved, but its direct guideline relevance and systematic review methodology justify inclusion as an addition rather than a modification of existing text.
Evidence
Content Changes
removedadded
<!-- type: guidelines --> **ACS-COT/NAEMSP Joint Statement (2019)** [@bulger2019]: resuscitative endovascular balloon occlusion of the aorta (REBOA) may be considered for noncompressible torso hemorrhage in systems with appropriate training, governance, and rapid transition to definitive control. The statement emphasizes minimizing occlusion time and appropriate patient selection. **WSES Pelvic Trauma Guidelines (2017)** [@coccolini2017-wses]: Angioembolization is recommended as first-line therapy for ongoing pelvic hemorrhage where available, with preperitoneal pelvic packing as a complementary strategy. **endovascular trauma management (EVTM) Consensus**: Endovascular resuscitation encompasses access, embolization, stents, shunts, hybrid surgery, and tailored use of REBOA [@trauma2016-endovascular]. See [[Vascular Trauma]] for ESVS Vascular Injuries Guidelines. **Endovascular Management of Hemorrhage in Polytrauma — Guideline Update (2025)** [@wagner2025-n]: A systematic review and clinical practice guideline update addressing endovascular management of hemorrhage and vascular lesions in patients with multiple and/or severe injuries provides updated evidence-based recommendations on patient selection, technique, and integration of endovascular approaches within damage-control resuscitation pathways [@wagner2025-n].