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.

In electrocardiographic (ECG)-gated computed tomography (CT) for diagnosis of cardiac diseases, radiation dose and image quality are optimized by limiting field of view (FOV) and centering on the heart. However, it is necessary to set wide FOV with large bowtie filter depending on patient positioning or various diagnoses such as aortic diseases. The purpose of this study is to clarify influence of bowtie filter and patient positioning on in-plane dose distribution, organ-absorbed dose, image quality in ECG-gated CT. In-plane dose distribution and organabsorbed dose were evaluated with radio photoluminescence glass dosimeters, and signal-to-noise ratio (SNR) were measured for evaluation of image quality. The bowtie filter was used small (S) and large (L). With automatic exposure control, volume computed tomography dose index was 55.

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