2022
DOI: 10.1097/xcs.0000000000000436
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Endovascular Balloon Occlusion of the Inferior Vena Cava in Trauma: A Single-Center Case Series

Abstract: Injury to the inferior vena cava (IVC) can produce bleeding that is difficult to control. Endovascular balloon occlusion provides rapid vascular control without extensive dissection and may be useful in large venous injuries, especially in the juxtarenal IVC. We describe the procedural steps, technical considerations, and clinical scenarios for using the Bridge occlusion balloon (Philips) in IVC trauma. We present a single-center case series of 5 patients in which endovascular balloon occlusion of the IVC was … Show more

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Cited by 6 publications
(5 citation statements)
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“…Originally designed for superior vena cava injuries sustained during pacemaker lead extractions, the Bridge balloon is advanced over a wire with confirmation of the balloon position by direct palpation within the laparotomy exposure. Of the 5 patients in the small series by Howell et al , all survived the index operation with a median total blood product transfusion of 37 units (range 16 to 77 units), consistent with the severe hemorrhage associated with vena cava injuries [75 ▪ ]. All except 1 survived to discharge.…”
Section: Damage Control In the Endovascular Eramentioning
confidence: 68%
“…Originally designed for superior vena cava injuries sustained during pacemaker lead extractions, the Bridge balloon is advanced over a wire with confirmation of the balloon position by direct palpation within the laparotomy exposure. Of the 5 patients in the small series by Howell et al , all survived the index operation with a median total blood product transfusion of 37 units (range 16 to 77 units), consistent with the severe hemorrhage associated with vena cava injuries [75 ▪ ]. All except 1 survived to discharge.…”
Section: Damage Control In the Endovascular Eramentioning
confidence: 68%
“…Case reports where REBOVC has been used as a bridge to surgery in hemorrhagic shock and patients in extremis have been published 3 4 27. A recent report from Baltimore, presenting the use of REBOVC in five trauma patients, provides support for successful clinical use of REBOVC in the management of vena cava injuries 5. The use of REBOVC as an adjunct to REBOA in vena cava injuries is a new tool, recommended under very special circumstances.…”
Section: Discussionmentioning
confidence: 99%
“… 3 4 27 A recent report from Baltimore, presenting the use of REBOVC in five trauma patients, provides support for successful clinical use of REBOVC in the management of vena cava injuries. 5 The use of REBOVC as an adjunct to REBOA in vena cava injuries is a new tool, recommended under very special circumstances. REBOVC may be considered a tool for the hybrid management of vena cava injuries, where vascular control is achieved by combining endovascular techniques with definitive open surgical repair.…”
Section: Discussionmentioning
confidence: 99%
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“…Resuscitative balloon occlusion of the aorta has been used in patients with caval gunshot wounds to reverse hypotension and there are emerging case reports suggesting that balloon occlusion of the inferior vena cava can be used in concert with Reboa to facilitate caval repair [10]. Massive transfusion protocols (MTP) are necessary in most of these cases as blood loss can be rapid.…”
Section: Issn:2993-1126mentioning
confidence: 99%