Anchoring and migration of balloon in REBOA

2021 ◽  
Vol 927 ◽  
Author(s):  
C.C. Mei ◽  
Y.L. Li ◽  
S. Michele ◽  
P. Sammarco ◽  
P.B. McBeth
Keyword(s):  
Blood Flow ◽  
Viscoelastic Model ◽  
Balloon Occlusion ◽  
Pressure Waves ◽  
Lubrication Approximation ◽  
Mechanical Theory ◽  
Inflation Pressure ◽  
Solid Friction ◽  
And Migration ◽  
Endovascular Balloon Occlusion

A mechanical theory is described for a phenomenon in the surgical procedure of resuscitative endovascular balloon occlusion of the aorta (REBOA). In this procedure a balloon is pushed into the aorta by a catheter and then inflated in order to stop haemorrhage. One of the hazards of this procedure is the tendency for the balloon to migrate away from its intended position. This work examines the mechanics of balloon anchoring and migration by analysing the effects of pressure waves, the sheet flow and solid friction in the thin gap between the walls of the aorta and balloon. A viscoelastic model is adopted for the aorta wall for pressure waves between the left ventricle and the balloon. The lubrication approximation is used for blood flow in the thin gap between the walls of the balloon and aorta. Samples of quantitative predictions are discussed on how the inflation pressure and balloon characteristics affect the balloon anchoring and migration. The crucial roles of solid friction and balloon placement are pointed out, which should help in guiding the manufacturing of balloons and their usage in the field.

Blood flow of the venous system during resuscitative endovascular balloon occlusion of the aorta

2020 ◽  
Vol 88 (2) ◽  
pp. 305-309 ◽  
Author(s):  
Yoshimitsu Izawa ◽  
Shuji Hishikawa ◽  
Yosuke Matsumura ◽  
Hiroyasu Nakamura ◽  
Hideharu Sugimoto ◽  
...  
Keyword(s):  
Blood Flow ◽  
Balloon Occlusion ◽  
Venous System ◽  
Endovascular Balloon Occlusion

Resuscitative Endovascular Balloon Occlusion of the Aorta: A Bridge to Flight Survival

2018 ◽  
Vol 38 (2) ◽  
pp. 69-75 ◽  
Author(s):  
Carl Goforth ◽  
Matthew Bradley ◽  
Benilani Pineda ◽  
Suzanne See ◽  
Jason Pasley
Keyword(s):  
Blood Flow ◽  
Cause Of Death ◽  
Abdominal Aorta ◽  
Balloon Occlusion ◽  
Treatment Facility ◽  
Potential Intervention ◽  
Injured Person ◽  
Initial Injury ◽  
Aeromedical Transport ◽  
Endovascular Balloon Occlusion

Trauma endures as the leading cause of death worldwide, and most deaths occur in the first 24 hours after initial injury as a result of hemorrhage. Historically, about 90% of battlefield deaths occur before the injured person arrives at a theater hospital, and most are due to noncompressible hemorrhage of the torso. Resuscitative endovascular balloon occlusion of the aorta is an evolving technique to quickly place a balloon into the thoracic or abdominal aorta to efficiently block blood flow to distal circulation. Maneuvers, such as resuscitative endovascular balloon occlusion of the aorta, to control endovascular hemorrhage offer a potential intervention to control noncompressible hemorrhage. This technique can be performed percutaneously or open in prehospital environments to restore hemodynamic functions and serve as a survival bridge until the patient is delivered to a treatment facility for definitive surgical hemostasis. This article describes the indications, complications, and application of resuscitative endovascular balloon occlusion of the aorta to military and civilian aeromedical transport.

scholarly journals Resuscitative endovascular balloon occlusion of the aorta vs epinephrine in the treatment of non-traumatic cardiac arrest in swine

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alice Hutin ◽  
Yaël Levy ◽  
Fanny Lidouren ◽  
Matthias Kohlhauer ◽  
Pierre Carli ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cardiac Arrest ◽  
Life Support ◽  
Statistical Significance ◽  
Spontaneous Circulation ◽  
Balloon Occlusion ◽  
Swine Model ◽  
Epinephrine Administration ◽  
Traumatic Cardiac Arrest ◽  
Endovascular Balloon Occlusion

Abstract Background The administration of epinephrine in the management of non-traumatic cardiac arrest remains recommended despite controversial effects on neurologic outcome. The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) could be an interesting alternative. The aim of this study was to compare the effects of these 2 strategies on return of spontaneous circulation (ROSC) and cerebral hemodynamics during cardiopulmonary resuscitation (CPR) in a swine model of non-traumatic cardiac arrest. Results Anesthetized pigs were instrumented and submitted to ventricular fibrillation. After 4 min of no-flow and 18 min of basic life support (BLS) using a mechanical CPR device, animals were randomly submitted to either REBOA or epinephrine administration before defibrillation attempts. Six animals were included in each experimental group (Epinephrine or REBOA). Hemodynamic parameters were similar in both groups during BLS, i.e., before randomization. After epinephrine administration or REBOA, mean arterial pressure, coronary and cerebral perfusion pressures similarly increased in both groups. However, carotid blood flow (CBF) and cerebral regional oxygenation saturation were significantly higher with REBOA as compared to epinephrine administration (+ 125% and + 40%, respectively). ROSC was obtained in 5 animals in both groups. After resuscitation, CBF remained lower in the epinephrine group as compared to REBOA, but it did not achieve statistical significance. Conclusions During CPR, REBOA is as efficient as epinephrine to facilitate ROSC. Unlike epinephrine, REBOA transitorily increases cerebral blood flow and could avoid its cerebral detrimental effects during CPR. These experimental findings suggest that the use of REBOA could be beneficial in the treatment of non-traumatic cardiac arrest.

scholarly journals Assessment of Blood Flow Patterns Distal to Aortic Occlusion (AO) Using Computed Tomography in Patients with Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)

2017 ◽  
Vol 225 (4) ◽  
pp. S50
Author(s):  
Philip Wasicek ◽  
Kathirkamanathan Shanmuganathan ◽  
William A. Teeter ◽  
William B. Gamble ◽  
Peter F. Hu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Blood Flow ◽  
Flow Patterns ◽  
Balloon Occlusion ◽  
Aortic Occlusion ◽  
Blood Flow Patterns ◽  
Endovascular Balloon Occlusion

Assessment of Blood Flow Patterns Distal to Aortic Occlusion Using CT in Patients with Resuscitative Endovascular Balloon Occlusion of the Aorta

2018 ◽  
Vol 226 (3) ◽  
pp. 294-308 ◽  
Author(s):  
Philip J. Wasicek ◽  
Kathirkamanathan Shanmuganathan ◽  
William A. Teeter ◽  
William B. Gamble ◽  
Peter Hu ◽  
...  
Keyword(s):  
Blood Flow ◽  
Flow Patterns ◽  
Balloon Occlusion ◽  
Aortic Occlusion ◽  
Blood Flow Patterns ◽  
Endovascular Balloon Occlusion

Short-term fetoscopic tracheal balloon occlusion permits lung distension and improves pulmonary blood flow prior to delivery in a hydropic fetus with hydrothorax

2013 ◽  
Vol 34 (S 01) ◽  
Author(s):  
T Kohl ◽  
A Khaleeva ◽  
H Ehrhardt ◽  
D Faas ◽  
J Degenhardt ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pulmonary Blood Flow ◽  
Balloon Occlusion ◽  
Short Term

Successful Control of Massive Vaginal Bleeding with Resuscitative Endovascular Balloon Occlusion of the Aorta and Pelvic Packing

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Emre Özlüer ◽  
Çagaç Yetis ◽  
Evrim Sayin ◽  
Mücahit Avcil
Keyword(s):  
Vaginal Bleeding ◽  
Balloon Occlusion ◽  
Emergency Physicians ◽  
Pelvic Packing ◽  
Gynecological Malignancies ◽  
Life Threatening ◽  
Successful Control ◽  
Endovascular Balloon Occlusion

Gynecological malignancies may present as life-threatening vaginal bleeding. Pelvic packing and Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) may be useful along with conventional vaginal packing when in terms of control of the hemorrhage. Emergency physicians should be able to perform these interventions promptly in order to save their patients from exsanguination.

AORTA Registry 7F vs 11-12 F access

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Reviewer Joseph DuBose ◽  
Jonathan Morrison ◽  
Megan Brenner ◽  
Laura Moore ◽  
John B Holcomb ◽  
...  
Keyword(s):  
Ultrasound Guidance ◽  
Balloon Occlusion ◽  
Aortic Occlusion ◽  
Severely Injured ◽  
Distal Extremity ◽  
Low Profile ◽  
Transfusion Requirements ◽  
Thrombotic Complications ◽  
Device Use ◽  
Endovascular Balloon Occlusion

ABSTRACT Introduction:  The introduction of low profile devices designed for Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) after trauma has the potential to change practice, outcomes and complication profiles related to this procedure. Methods: The AAST Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery (AORTA) registry was utilized to identify REBOA patients from 16 centers -comparing presentation, intervention and outcome variables for those REBOA via traditional 11-12 access platforms and trauma-specific devices requiring only 7 F access. Results:From Nov 2013-Dec 2017, 242 patients with completed data were identified, constituting 124 7F and 118 11-12F uses. Demographics of presentation were not different between the two groups, except that the 7F patients had a higher mean ISS (39.2 34.1, p = 0.028). 7F device use was associated with a lower cut-down requirement for access (22.6% vs. 37.3%, p = 0.049) and increased ultrasound guidance utilization (29.0% 23.7%, p = 0.049). 7F device afforded earlier aortic occlusion in the course of resuscitation (median 25.0 mins vs. 30 mins, p = 0.010), and had lower median PRBC (10.0 vs. 15.5 units, p = 0.006) and FFP requirements (7.5 vs. 14.0 units, p = 0.005). 7F patients were more likely to survive 24 hrs (58.1% vs. 42.4%, p = 0.015) and less likely to suffer in-hospital mortality (57.3% vs. 75.4%, p = 0.003). Finally, 7F device use was associated with a 4X lower rate of distal extremity embolism (20.0% vs. 5.6%, p = 0.014;OR 95% CI 4.25 [1.25-14.45]) compared to 11-12F counterparts. Conclusion: The introduction of trauma specific 7F REBOA devices appears to have influenced REBOA practices, with earlier utilization in severely injured hypotensive patients via less invasive means that are associated with lower transfusion requirements fewer thrombotic complications and improved survival. Additional study is required to determine optimal REBOA utilization.

Resuscitative endovascular balloon occlusion of the aorta (REBOA) enables operative management of the peripartum trauma patient in hemorrhagic shock

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Kelvin Allenson ◽  
Laura Moore
Keyword(s):  
Maternal Death ◽  
Motor Vehicle ◽  
Operative Management ◽  
Balloon Occlusion ◽  
Motor Vehicle Accidents ◽  
Gravid Uterus ◽  
Intrauterine Pregnancy ◽  
Vehicle Accidents ◽  
Pelvic Hemorrhage ◽  
Endovascular Balloon Occlusion

Trauma related injury is the leading cause of non-obstetric maternal death.  The gravid uterus is at risk for injury, particularly during motor vehicle accidents.  Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a means of controlling pelvic hemorrhage in the setting of trauma.  We report the use of REBOA in a hemodynamically unstable, multiply-injured young woman with viable intrauterine pregnancy.

Use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) as a bridge to endovascular aortic repair (EVAR) in blunt abdominal aortic injury (BAAI).

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Valentina Chiarini
Keyword(s):  
Trauma Center ◽  
Aortic Rupture ◽  
Damage Control ◽  
Aortic Injury ◽  
Balloon Occlusion ◽  
Traumatic Lesion ◽  
Abdominal Aortic ◽  
Aortic Injuries ◽  
Accepted Practice ◽  
Endovascular Balloon Occlusion

BAAI is a rare but challenging traumatic lesion. Since BAAI is difficult to suspect and diagnose, frequently lethal and associated to multiorgan injuries, its management is objective of research and discussion. REBOA is an accepted practice in ruptured abdominal aortic aneurysm. Conversely, blunt aortic injuries are the currently most cited contraindications for the use of REBOA in trauma, together with thoracic lesions. We reported a case of BAAI safely managed in our Trauma Center at Maggiore Hospital in Bologna (Italy) utilizing REBOA as a bridge to endovascular repair, since there were no imminent indications for laparotomy. Despite formal contraindication to placing REBOA in aortic rupture, we hypothesized that this approach could be feasible and relatively safe when introduced in a resuscitative damage control protocol.

Sign in / Sign up

Export Citation Format

Share Document