A new method using surface landmarks to locate resuscitative endovascular balloon occlusion of the aorta based on a retrospective CTA study

Weng, Danlei; Qian, Anyu; Zhou, Qing; Xu, Jiefeng; Xu, Shan-xiang; Zhang, Mao

doi:10.1007/s00068-021-01686-0

Cited by 6 publications

(2 citation statements)

References 20 publications

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“…If no fluoroscopic or ultrasound devices are available at the site of first aid, REBOA was implemented using body surface landmarks, such as xiphoid or umbilicus to predict the length of REBOA catheter to be placed into the body. [ 20 ] Inflation/deflation of the balloon: Physiological saline (or contrast agent) is injected into the balloon for inflation. The size and expansion pressure of the balloon are closely observed to avoid overinflation, and the proximal/distal arterial pressure is monitored.…”

Section: Resultsmentioning

confidence: 99%

Common complications and prevention strategies for resuscitative endovascular balloon occlusion of the aorta: A narrative review

Guan,

Chen,

Zhou

et al. 2023

Medicine

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Resuscitative endovascular balloon occlusion of the aorta (REBOA) is considered a key measure of treatment due to its use in stabilizing patients in shock through temporary inflow occlusion for noncompressible torso hemorrhage as well as its supportive role in myocardial and cerebral perfusion. Although its clinical efficacy in trauma has been widely recognized, concerns over related complications, such as vascular access and ischemia-reperfusion, are on the rise. This paper aims to investigate complications associated with REBOA and identify current and emerging prevention or mitigation strategies through a literature review based on human or animal data. Common complications associated with REBOA include ischemia/reperfusion injuries, vessel injuries, venous thromboembolism, and worsening proximal bleeding. REBOA treatment outcomes can be improved substantially with the help of precise selection of patients, better visualization tools, improvement in balloon catheters, blockage strategies, and medication intervention measures. Better understanding of REBOA-related complications and further research on the strategies to mitigate the occurrence of such complications will be of vital importance for the optimization of the clinical outcomes in patients.

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Section: Resultsmentioning

confidence: 99%

Common complications and prevention strategies for resuscitative endovascular balloon occlusion of the aorta: A narrative review

Guan,

Chen,

Zhou

et al. 2023

Medicine

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“…Previously, fluoroscopy-free placement during postpartum hemorrhage has been described by Stensaeth and colleagues, 23 as well as in trauma surgery literature while relying on surface landmarks as guidance for placement. 24 An experienced gynecologic oncologist can use their knowledge of pelvic/lower abdominal anatomy garnered from advanced surgical training to guide balloon inflation in distal aortic zone 3 in partnership with ACS team members. Our study illustrated that REBOA can also be placed distally in aortic zone 3 without compromising the decrease in PRBC requirement and avoiding occlusion of circulation to vital abdominopelvic organs.…”

Section: Discussionmentioning

confidence: 99%

When the balloon goes up, blood transfusion goes down: a pilot study of REBOA in placenta accreta spectrum disorders

Ioffe

Burruss

Yao

et al. 2021

Trauma Surg Acute Care Open

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BackgroundPatients with placenta accreta spectrum (PAS) disorders often suffer massive hemorrhage during cesarean hysterectomies (CHyst). A novel strategy to decrease blood loss and minimize perioperative morbidity associated with PAS is utilization of ER-REBOA Catheter intraoperatively. In this study, we explore the use of ER-REBOA Catheter during CHyst with the goal of minimizing perioperative morbidity and packed red blood cell (PRBC) transfusions.MethodsWe conducted a retrospective case–control study at a regional referral center of consecutive patients with PAS undergoing CHyst. The primary outcomes were PRBC transfusions of ≥4 units. Secondary outcomes included surgical intensive care unit admissions, postoperative length of stay (LOS), postoperative ileus, and vascular complication rate. We also explored utilization of manual palpation and omission of precesarean fluoroscopy for resuscitative endovascular balloon occlusion of the aorta (REBOA) placement verification in distal aortic zone 3.Results90 patients were included in the study. REBOA and non-REBOA cases were similar in clinicodemographic characteristics. 17.7% of REBOA cases received ≥4 units of PRBC compared with 49.3% of non-REBOA cases (p=0.03). Zero REBOA patients developed postoperative ileus, whereas 18 (25%) non-REBOA patients did (p=0.02). LOS was reduced in the REBOA group. Postplacement fluoroscopy was omitted in all REBOA cases. Two postoperative arterial thrombotic events (2 of 19, 11% of REBOA patients) were identified in the REBOA group, one requiring a thrombectomy (1 of 19, 5%).DiscussionDecrease in blood transfusions of ≥4 units of PRBC is demonstrated when ER-REBOA Catheter is placed in distal aortic zone 3 during CHyst performed for severe PAS disorders. The incidence of postoperative ileus and LOS are reduced in the ER-REBOA Catheter group. Placement and utilization of ER-REBOA Catheter during CHyst may be feasible without fluoroscopy when manual placement verification is performed by an experienced operator. Protocol modifications focusing on reducing thrombotic rate are ongoing.Level of evidenceIV.

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Age affects vascular morphology and predictiveness of anatomical landmarks for aortic zones in trauma patients: implications for resuscitative endovascular balloon occlusion of the aorta

Li,

Gong,

et al. 2024

Eur J Trauma Emerg Surg

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A new method using surface landmarks to locate resuscitative endovascular balloon occlusion of the aorta based on a retrospective CTA study

Cited by 6 publications

References 20 publications

Common complications and prevention strategies for resuscitative endovascular balloon occlusion of the aorta: A narrative review

Common complications and prevention strategies for resuscitative endovascular balloon occlusion of the aorta: A narrative review

When the balloon goes up, blood transfusion goes down: a pilot study of REBOA in placenta accreta spectrum disorders

Age affects vascular morphology and predictiveness of anatomical landmarks for aortic zones in trauma patients: implications for resuscitative endovascular balloon occlusion of the aorta

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