Hybrid use of REBOA in a South African tertiary trauma unit for penetrating torso trauma

Khan, Muhammad Zafar; Bruce, John; Baer, David G.; Hoencamp, Rigo

doi:10.1136/bcr-2019-229538

Cited by 5 publications

(2 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The approach of a modern hybrid operating theatre with advanced imaging and endovascular capacity, as well as open surgical capacity, may improve outcomes for IVC trauma. Retrograde balloon endovascular occlusion of the aorta (REBOA) may be able to improve outcome for intra‐abdominal vascular injuries [13]. REBOA allows for inflow control of an aortic injury and facilitates control and repair of an aortic injury.…”

Section: Discussionmentioning

confidence: 99%

Despite Major Therapeutic Advances, Vena Caval Trauma Remains Associated with Significant Morbidity and Mortality

Khan

Mbebe

et al. 2022

World j. surg.

Self Cite

View full text Add to dashboard Cite

Background Penetrating inferior vena caval injuries remain a challenging operative entity. This study reviews our local experience with the injury over a nine‐year period and attempts to contextualize it within the published literature that emanates from South Africa on the topic. Methods A single‐centre retrospective review of prospectively collected data was performed of all patients who underwent a laparotomy for a penetrating IVC injury. Descriptive statistics were calculated for demographics, clinical and biochemical parameters, intraoperative data, ICU admission and outcomes. Results During the nine‐year period, thirty‐five patients sustained penetrating injuries to the IVC. Mechanism of injury included 25 low velocity gunshots (71%) and 10 stab wounds (29%). The anatomical location included two (6%) supra‐renal, six (17%) juxta‐renal and 27 (77%) infra‐renal injuries. Venorrhaphy was performed in 22 cases (63%) and ligation in 13 (37%). Average ICU stay was 5.4 days. Thirteen patients died (37%), of which six (46%) died within 24 h of arrival. Conclusion Despite dramatic improvements in surgical trauma care over the last four decades, penetrating injury to the IVC carries a high mortality rate ranging from 31 to 37%. It is unlikely that further improvements can be achieved by refining operative techniques and approaches to resuscitation. Future endeavours must focus on applying the burgeoning understanding of endovascular surgery to these injuries.

show abstract

Section: Discussionmentioning

confidence: 99%

Despite Major Therapeutic Advances, Vena Caval Trauma Remains Associated with Significant Morbidity and Mortality

Khan

Mbebe

et al. 2022

World j. surg.

Self Cite

View full text Add to dashboard Cite

show abstract

“…These VCDs do not require any preprocedural preparations. Khan et al described an alternative route for vascular access [18]. In their case, the aorta was punctured directly to place an ER-REBOA™ during laparotomy of a patient in extremis from multicavity penetrating trauma.…”

Section: Discussionmentioning

confidence: 99%

A contemporary assessment of devices for Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): resource-specific options per level of care

Vrancken

Burg

Vrancken

et al. 2020

Eur J Trauma Emerg Surg

Self Cite

View full text Add to dashboard Cite

Purpose Use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) as adjunct for temporary hemorrhage control in patients with exsanguinating torso hemorrhage is increasing. Characteristics of aortic occlusion balloons (AOB) are diverse and evolving as efforts are made to improve the technology. It is important to select a device that fits the requirements of the medical situation to minimize the risk of failure and complications. The aim of this study is to appraise guidance in the choice of an AOB in a specific situation. Methods We assessed 29 AOB for differences and outline possible advantages and disadvantages of each. Bending stiffness was measured with a three-point bending device. Results Diameter of the AOB ranged from 6 (ER-REBOA™) to 10 (Coda ®-46) French. However, some need large-bore access sheaths up to 22 French (Fogarty ®-45 and LeMaitre ®-45) or even insertion via cut-down (Equalizer™-40). Bending stiffness varied from 0.08 N/mm (± 0.008 SD; Coda ®-32) to 0.72 N/mm (± 0.024 SD; Russian prototype). Rescue Balloon™ showed kinking of the shaft at low bending pressures. The only non-compliant AOB is REBOA Balloon ®. ER-REBOA™, Fogarty ® , LeMaitre ® , REBOA Balloon ® , and Rescue Balloon™ are provided with external length marks to assist blind positioning. Conclusion In resource-limited settings, a guidewire-and fluoroscopy-free, rather stiff device, such as ER-REBOA™, Fogarty ® , and LeMaitre ® , is warranted. Of these devices, ER-REBOA™ is the only catheter compatible with seven French sheaths and specifically designed for emergency hemorrhage control. Of the over-the-wire devices, Q50 ® has several features that facilitate use and reduce the risk of malplacement or vessel damage.

show abstract

Non-compressible truncal and junctional hemorrhage: A retrospective analysis quantifying potential indications for advanced bleeding control in Dutch trauma centers

Vrancken,

de Vroome,

van Vledder

et al. 2024

Injury

View full text Add to dashboard Cite

Hybrid use of REBOA in a South African tertiary trauma unit for penetrating torso trauma

Cited by 5 publications

References 7 publications

Despite Major Therapeutic Advances, Vena Caval Trauma Remains Associated with Significant Morbidity and Mortality

Despite Major Therapeutic Advances, Vena Caval Trauma Remains Associated with Significant Morbidity and Mortality

A contemporary assessment of devices for Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): resource-specific options per level of care

Non-compressible truncal and junctional hemorrhage: A retrospective analysis quantifying potential indications for advanced bleeding control in Dutch trauma centers

Contact Info

Product

Resources

About