The utilization of resuscitative endovascular balloon occlusion of the aorta: preparation, technique, and the implementation of a novel approach to stabilizing hemorrhage

Abstract

Noncompressible torso hemorrhage (NCTH), if not controlled promptly, leads to death. In the acute setting, aortic occlusion can be performed as damage control surgery (DCS) for hemorrhage originating from the abdomen and pelvis. With the development of endovascular technology, an intra-aortic balloon can be used to achieve aortic occlusion and decrease hemorrhage. Recently, resuscitative endovascular balloon occlusion of the aorta (REBOA) has been accepted as a salvage technique for the temporary stabilization of patients with NCTH. However, balloon occlusion is not easily performed in trauma patients. In this article, we described preparation, technical description, and conceptual understanding of REBOA.

Feasibility Study of Precise Balloon Catheter Tracking and Visualization with Fast Photoacoustic Microscopy

“…If a large amount of bleeding occurs from the aorta, the inflation of resuscitative balloon catheters can lead to blocking blood leakage from the perforated site [ 7 ]. Such the balloon catheter procedure can increase blood flow to the heart and brain, thus preventing cardiovascular collapse [ 8 ]. Recently, given a less-invasiveness of catheterization, a new hybrid operation which is combining open surgery and vascular intervention has been used in many cases such as heart disease [ 9 ], liver injury [ 10 ], subclavian artery injury [ 11 ], and lower extremity vascular injury [ 12 ].…”

Intraoperative Use of Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhage Control in Woman with Placenta Percreta Involving the Bladder

“…2,3 Cur rently, resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed as damage control surgery for a patient with a noncompressible torso hemorrhage (NCTH), such as a massive hemorrhage originating from the abdomen or pelvis, to decrease hemorr haging below the occlusion and increase the perfusion of the heart and brain during hemorr hagic shock. 5,6 In this regard, the use of REBOA may be a lifesaving procedure in patients with peripartum hemorrhage; however, the REBOA procedure has not yet been widely used to mitigate peripartum hemorrhaging due to widespread lack of knowledge and experience.…”

“…REBOA has increasingly been used at many centers as a re suscitative adjunct for trauma patients with lifethreatening NCTH. 5,6 REBOA helps provide time for resuscitation while pre serving cerebral perfusion and coronary filling in the setting of fatal hypotension and hypovolemia secondary to hemorrhage. In patients with uncontrollable peripartum hemorrhaging, REBOA may also play a crucial role in bridging management and defini tive bleeding control, which may contribute to decreased mor bidity and mortality.…”

A Course on Endovascular Training for Resuscitative Endovascular Balloon Occlusion of the Aorta (ET-REBOA): A Pilot Study for Residents and Specialists

“…Recently, REBOA has been gaining acceptance as an alternative to RT followed by ACC in the management of select patients with NCTH [4][5][6][7]. The paradigm is shifting with respect to the management of hemorrhagic shock from abdominopelvic injury since REBOA provides the physiologic benefit of temporary aortic occlusion without the burden of thoracotomy [8].…”