REBOA – new era of bleeding control, literature review

Marciniuk, Piotr; Pawlaczyk, Rafał; Rogowski, Jan; Wojciechowski, Jacek; Znaniecki, Łukasz

doi:10.5604/01.3001.0013.5426

Cited by 7 publications

(11 citation statements)

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“…Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive procedure being increasingly utilized to prevent patients with non-compressible torso hemorrhage (NCTH) from exsanguination. It is used as a bridge to surgical bleeding control to gain time during the management of hemorrhagic shock as part of the endovascular resuscitation and trauma management (EVTM) concept [ 1 – 7 ]. Access to the common femoral artery (CFA) is essential for performing REBOA and is regularly gained by different medical specialists including vascular surgeons, interventional radiologists, anesthetists, and emergency physicians [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Successfully REBOA performance: does medical specialty matter? International data from the ABOTrauma Registry

et al. 2020

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Background Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive procedure being increasingly utilized to prevent patients with non-compressible torso hemorrhage from exsanguination. The increased use of REBOA is giving rise to discussion about “Who is and who should be performing it?” Methods Data from the international ABO (aortic balloon occlusion) Trauma Registry from between November 2014 and April 2020 were analyzed concerning the question: By who, how, and where is REBOA being performed? The registry collects retrospective and prospective data concerning use of REBOA in trauma patients. Results During the study period, 259 patients had been recorded in the registry, 72.5% (n = 188) were males with a median (range) age of 46 (10-96) years. REBOA was performed in the ER in 50.5%, in the OR in 41.5%, and in the angiography suite in 8% of patients. In 54% of the patients REBOA was performed by surgeons (trauma surgeons 28%, vascular surgeons 22%, general surgeons 4%) and in 46% of the patients by non-surgeons (emergency physicians 31%, radiologists 9.5%, anesthetists 5.5%). Common femoral artery (CFA) access was achieved by use of external anatomic landmarks and palpation alone in 119 patients (51%), by cutdown in 57 patients (24%), using ultrasound in 49 patients (21%), and by fluoroscopy in 9 patients (4%). Significant differences between surgeons and non-surgeons were found regarding patient’s age, injury severity, access methods, place where REBOA was performed, location patients were taken to from the emergency room, and mortality. Conclusion A substantial number of both surgical and non-surgical medical disciplines are successfully performing REBOA to an almost equal extent. Surgical cutdown is used less frequently as access to the CFA compared with reports in older literature and puncture by use of external anatomic landmarks and palpation alone is used with a high rate of success. Instead of discussing “Who should be performing REBOA?” future research should focus on “Which patient benefits most from REBOA?”

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Section: Introductionmentioning

confidence: 99%

Successfully REBOA performance: does medical specialty matter? International data from the ABOTrauma Registry

et al. 2020

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“…В настоящее время с целью предупреждения такого кровотечения или обеспечения быстрого проксимального контроля при развившемся кровотечении благодаря «эндоваскулярной революции» большое внимание уделяется малоинвазивным технологиям. Изначально внутрисосудистые методы использовались при ранениях и травмах только как метод контроля проксимального кровотечения, но уже сегодня они способны обеспечить окончательный гемостаз и могут быть выполнены даже у гемодинамически нестабильных пациентов [2][3][4][5][6].…”

Section: эндоваскулярные методы контроля кровотеченийunclassified

“…Николай Иванович Пирогов писал: «Для хирургии настала бы новая эра, если бы удалось быстро и верно останавливать кровотечение из крупной артерии, не обнажая ее и не перевязывая ее». В 2017 г. был проведен первый международный симпозиум общества EVTM (Endovascular Resuscitation and Trauma Management), которое объединяет специалистов, занимающихся лечением травматических и нетравматических кровотечений и связанных с ними состояний [4,5].…”

Section: эндоваскулярные методы контроля кровотеченийunclassified

“…В англоязычной литературе такое кровотечение называется «non-compressible truncal hemorrhage», или «несдавливаемое внутриполостное кровотечение». К такому кровотечению относят: травматические кровотечения грудной и брюшной полостей, ретроперитонеального пространства и тазовые кровотечения; различные кровотечения в сосудистой хирургии (осложненные аневризмы, ятрогенные повреждения сосудов), в абдоминальной хирургии (желудочно-кишечное кровотечение, аррозивные парапанкреатические кровотечения) и в акушерстве (приращение плаценты) [2][3][4].…”

Section: Introductionunclassified

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Endovascular Methods of Bleeding Management

Бут-Гусаим¹,

Воробей²,

Давидовский³

et al. 2021

Хирургия. Восточная Европа

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Кровотечение является одной из главных проблем хирургии и травматологии. Методы контроля и остановки кровотечения постоянно совершенствуются. Развитие эндоваскулярной хирургии значительно расширило возможности оказания помощи пациентам с кровотечениями различной этиологии. Эндоваскулярные методы контроля кровотечений позволяют обеспечить эффективный временный проксимальный контроль или окончательный гемостаз при кровотечениях из труднодоступных зон. К таким методам относятся реанимационная эндоваскулярная баллонная окклюзия аорты, временная баллонная окклюзия сосудов, эмболизация артерий, эндопротезирование аорты и крупных артерий. Как пример использования эндоваскулярного метода контроля кровотечения при хирургическом лечении с крайне высоким риском кровотечения представлен клинический случай. Успешное внедрение таких методов в клиническую практику позволит снизить количество и тяжесть кровотечений при выполнении различных операций на крупных сосудах, органах брюшной полости, забрюшинного пространства и малого таза. Bleeding remains one of the main issues in surgery and traumatology. Bleeding management methods are constantly improved. The options of bleeding management have been significantly expanded due to development of endovascular surgery. Endovascular methods of bleeding management provide either effective temporary proximal bleeding control or final hemostasis in case of bleeding from hard-to-reach areas. These methods include resuscitation endovascular balloon occlusion of the aorta, temporary balloon vascular occlusion, embolization of arteries, endoprosthetics of the aorta and major arteries. A clinical case is presented as an example of using the endovascular bleeding control method in surgical treatment with extremely high risk of bleeding. Successful introduction of such methods into clinical practice will reduce the number and severity of bleeding during performing various operations on major vessels, abdominal cavity, retroperitoneal and small pelvis space.

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“…Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is a minimally invasive procedure being increasingly utilized to prevent patients with non-compressible torso hemorrhage (NCTH) from exsanguination. It is used as a bridge to surgical bleeding control to gain time during the management of hemorrhagic shock as part of the EndoVascular resuscitation and Trauma Management (EVTM) concept (1)(2)(3)(4)(5)(6)(7). Access to the common femoral artery (CFA) is essential for performing REBOA and is regularly gained by different medical specialists including vascular surgeons, interventional radiologists, anesthetists, and emergency physicians (8).…”

Section: Introductionmentioning

confidence: 99%

Successfully REBOA Performance: Does Medical Specialty Matter? International Data From the ABOTrauma Registry.

Hilbert-Carius

McGreevy

Abu‐Zidan

et al. 2020

Preprint

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BackgroundResuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is a minimally invasive procedure being increasingly utilized to prevent patients with non-compressible torso hemorrhage from exsanguination. The increased use of REBOA is giving rise to discussion about “Who is and who should be performing it?”.MethodsData from the international ABO (Aortic Balloon Occlusion) Trauma registry from between November 2014 and April 2020 were analyzed concerning the question: By who, how and where is REBOA being performed? The registry collects retrospective and prospective data concerning use of REBOA in trauma patients.ResultsDuring the study period, 259 patients had been recorded in the registry, 72.5% (n=188) were males with a median (range) age of 46 (10-96) years. REBOA was performed in the ER in 50.5%, in the OR in 41.5% and in the angiography suite in 8% of patients. In 54% of the patients REBOA was performed by surgeons (trauma surgeons 28%, vascular surgeons 22%, general surgeons 4%) and in 46% of the patients by non-surgeons (emergency physicians 31%, radiologists 9.5%, anesthetists 5.5%). Common Femoral Artery (CFA) access was achieved by use of external anatomic landmarks and palpation alone in 119 patients (51%), by cut down in 57 patients (24%), using ultrasound in 49 patients (21%) and by fluoroscopy in 9 patients (4%). Significant differences between surgeons and non-surgeons were found regarding patient’s age, injury severity, access methods, place where REBOA was performed, location patients were taken to from the emergency room and mortality.ConclusionA substantial number of both surgical and non-surgical medical disciplines are successfully performing REBOA to an almost equal extent. Surgical cut down is used less frequently as access to the CFA compared with reports in older literature and puncture by use of external anatomic landmarks and palpation alone is used with a high rate of success. Instead of discussing “Who should be performing REBOA?” future research should focus on “Which patient benefits most from REBOA?”.

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REBOA – new era of bleeding control, literature review

Cited by 7 publications

References 0 publications

Successfully REBOA performance: does medical specialty matter? International data from the ABOTrauma Registry

Successfully REBOA performance: does medical specialty matter? International data from the ABOTrauma Registry

Endovascular Methods of Bleeding Management

Successfully REBOA Performance: Does Medical Specialty Matter? International Data From the ABOTrauma Registry.

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REBOA – new era of bleeding control, literature review

Cited by 7 publications

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Successfully REBOA performance: does medical specialty matter? International data from the ABOTrauma Registry

Successfully REBOA performance: does medical specialty matter? International data from the ABOTrauma Registry

Endovascular Methods of Bleeding Management

Successfully REBOA&nbsp;Performance: Does Medical Specialty Matter? International Data From the ABOTrauma&nbsp;Registry.

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Successfully REBOA Performance: Does Medical Specialty Matter? International Data From the ABOTrauma Registry.