BACKGROUND: A lower profile, FDA-approved device for aortic occlusion (AO) is available for REBOA. METHODS: Patients who received AO with the new device from February 2016 to February 2017 at 2 urban tertiary care centers were enrolled. RESULTS: 60 consecutive patients underwent REBOA; 44 (73.3%) following blunt trauma. 52 (88.1%) were male; mean age of 40 ± 18 years. 49 REBOAs were deployed in Zone 1, 11 in Zone 3.67.7% of patients in arrest achieved return of spontaneous circulation (ROSC). Overall in-hospital survival was 43%; 19% for patients in arrest and 69% for patients with refractory hypotension. Access and vascular procedural complications included iliac intimal injury requiring stent-graft (1), patch angioplasty of the CFA (1), and balloon ruptures (3). 5 amputations were required; 2 immediate completion amputations due to initial injury, and 3 delayed amputations after efforts to salvage severely mangled extremities were unsuccessful. CONCLUSION: Smaller introducer sheaths for REBOA are safe and effective but do not eliminate the need for surgical common femoral artery access. Patients can benefit from REBOA with acceptable survival rates.
BACKGROUND: A lower profile, FDA-approved device for aortic occlusion (AO) is available for REBOA. METHODS:Patients who received AO with the new device from February 2016 to February 2017 at 2 urban tertiary care centers were enrolled. RESULTS: 60 consecutive patients underwent REBOA; 44 (73.3%) following blunt trauma. 52 (88.1%) were male; mean age of 40 ± 18 years. 49 REBOAs were deployed in Zone 1, 11 in Zone 3.67.7% of patients in arrest achieved return of spontaneous circulation (ROSC). Overall in-hospital survival was 43%; 19% for patients in arrest and 69% for patients with refractory hypotension. Access and vascular procedural complications included iliac intimal injury requiring stent-graft (1), patch angioplasty of the CFA (1), and balloon ruptures (3). 5 amputations were required; 2 immediate completion amputations due to initial injury, and 3 delayed amputations after efforts to salvage severely mangled extremities were unsuccessful. CONCLUSION: Smaller introducer sheaths for REBOA are safe and effective but do not eliminate the need for surgical common femoral artery access. Patients can benefit from REBOA with acceptable survival rates.
Authors: Carlos A Ordoñez; Michael W Parra; Yaset Caicedo; Natalia Padilla; Fernando Rodríguez-Holguín; José Julián Serna; Alexander Salcedo; Alberto García; Claudia Orlas; Luis Fernando Pino; Ana Milena Del Valle; David Mejia; Juan Carlos Salamea-Molina; Megan Brenner; Tal Hörer Journal: Colomb Med (Cali) Date: 2020-12-30
Authors: Eileen M Bulger; Debra G Perina; Zaffer Qasim; Brian Beldowicz; Megan Brenner; Frances Guyette; Dennis Rowe; Christopher Scott Kang; Jennifer Gurney; Joseph DuBose; Bellal Joseph; Regan Lyon; Krista Kaups; Vidor E Friedman; Brian Eastridge; Ronald Stewart Journal: Trauma Surg Acute Care Open Date: 2019-09-20