Resuscitative endovascular balloon occlusion of the aorta for retroperitoneal hemorrhage and shock after ipsilateral antegrade angioplasty with vascular closure device

Abstract

Percutaneous intervention is widely used to treat peripheral vascular disease. Ipsilateral antegrade femoral arterial access for femoropopliteal disease provides a mechanical advantage with regard to wire and stent control; however, it is associated with vascular complications and significant morbidity and mortality secondary to retroperitoneal hemorrhage from a high puncture site or vascular closure device (VCD) failure. Currently, resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed as damage control surgery in patients with non-compressible torso hemorrhage. We describe a patient with hemorrhagic shock secondary to VCD failure, who was successfully treated by REBOA as damage control surgery. To our knowledge, this is the first reported case in the English literature of successful REBOA in a patient with hemorrhagic shock secondary to VCD failure.

Management Trend for Unstable Pelvic Bone Fractures in Regional Trauma Centers: Multi-Institutional Study in the Republic of Korea

“…In addition, the technique has been reported to prevent cardiac arrest and could be utilized for bridging procedures in cases requiring definite hemostatic treatment [19]. REBOA was only recently adopted in the Republic of Korea, and experience in technique is therefore limited [20,21]. In our study, REBOA was the most frequently used technique in 2018, but mortality was the highest in that year; it was not used as frequently in 2019-2020 compared with 2018.…”

Feasibility and Clinical Outcomes of Resuscitative Endovascular Balloon Occlusion of the Aorta in Patients with Traumatic Shock: A Single-Center 5-Year Experience

“…The treatment paradigm has shifted with advancements JCS in endovascular treatment methods [11]. REBOA has recently been used as an alternative to RT-ACC in traumatic shock patients with subdiaphragmatic hemorrhage [8,10,[12][13][14] as well as to treat hemorrhagic shock in non-trauma patients [15][16][17]. Furthermore, REBOA kits have been accepted as essential equipment in trauma bays and emergency rooms for the resuscitation of patients with traumatic shock [10].…”

Resuscitative Endovascular Balloon Occlusion of the Aorta for an Iliac Artery Aneurysm: Case Report

“…REBOA has been accepted as a technique for preoperatively reducing hemorrhage and increasing cerebral/coronary perfusion in patients with non-compressible torso hemorrhage (NCTH) [5][6][7]. Recently, its use has expanded beyond just trauma care to encompass other types of bleeding or resuscitation for hemodynamic stabilization [5][6][7][8].…”

“…REBOA has been accepted as a technique for preoperatively reducing hemorrhage and increasing cerebral/coronary perfusion in patients with non-compressible torso hemorrhage (NCTH) [5][6][7]. Recently, its use has expanded beyond just trauma care to encompass other types of bleeding or resuscitation for hemodynamic stabilization [5][6][7][8]. In general, different occlusion zones in the aorta could be used to block blood flow to the lower body with the following classification and indications: zone I REBOA (descending thoracic aorta, from the origin of the left subclavian artery to the celiac artery) for patients with hemoperitoneum and/or retroperitoneal hemorrhage and zone III REBOA (infrarenal abdominal aorta, from the renal artery to the aortic bifurcation) for patients with pelvic bleeding.…”