Resuscitative Endovascular Balloon Occlusion of the Aorta in the Management of a Gunshot Wound and Rupture of the Uterus

2021 ◽  
pp. 000313482110540
Author(s):  
Syed Sikandar Raza ◽  
Kevin Tyler ◽  
Rony J. Najjar
Keyword(s):  
Gunshot Wound ◽  
Imaging Techniques ◽  
Balloon Occlusion ◽  
Lower Abdomen ◽  
Inferior Epigastric Artery ◽  
Uterine Arteries ◽  
Epigastric Artery ◽  
Aortic Balloon Occlusion ◽  
Trauma In Pregnancy ◽  
Endovascular Balloon Occlusion

Trauma is the leading cause of non-obstetrical maternal death. A 19-year-old woman at 20 weeks’ gestation was brought to the emergency room after suffering a gunshot wound to the lower abdomen. Upon arrival, she was hemodynamically stable and imaging was obtained. CT revealed a rupture of the uterus with a partially extrauterine fetus, and the patient was immediately taken for an explorative laparotomy. Prior to the surgical start, the patient’s blood pressure declined and, subsequently, a resuscitative endovascular balloon occlusion of the aorta (REBOA) was placed. The fetus and placenta were delivered and both uterine arteries and the inferior epigastric artery were ligated. Following an unremarkable postoperative course, she was discharged on hospital day 17. The mainstay approach to trauma in pregnancy should be to utilize focused imaging techniques to assess extent of trauma and provide adequate circulation to vital organs. Aortic balloon occlusion may be considered as a viable strategy to enhance resuscitation.

Giant aneurysm of the petrous internal carotid artery: diagnosis and treatment

1998 ◽  
Vol 112 (2) ◽  
pp. 196-198 ◽  
Author(s):  
S. C. Coley ◽  
A. Clifton ◽  
J. Britton
Keyword(s):  
Hearing Loss ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Imaging Techniques ◽  
Giant Aneurysm ◽  
Balloon Occlusion ◽  
Fusiform Aneurysm ◽  
Non Invasive ◽  
Endovascular Balloon Occlusion

AbstractWe report the case of a giant fusiform aneurysm of the petrous internal carotid artery in a 15-year-old patient who had presented with headache, hearing loss and Horner's syndrome. Definitive radiological diagnosis was made by non-invasive imaging techniques, including magnetic resonance angiography (MRA). The aneurysm was obliterated by endovascular balloon occlusion following successful tolerance of test occlusion of the internal carotid artery.

scholarly journals Combined, Converted, and Prophylactic Use of Resuscitative Endovascular Balloon Occlusion of the Aorta for Severe Torso Trauma: A Retrospective Study

2021 ◽  
Author(s):  
Takayuki Irahara ◽  
Dai Oishi ◽  
Masanobu Tsuda ◽  
Yuka Kajita ◽  
Hisatake Mori ◽  
...  
Keyword(s):  
Cardiopulmonary Arrest ◽  
Survival Rates ◽  
Balloon Occlusion ◽  
Shock Group ◽  
Total Occlusion ◽  
Occlusion Time ◽  
Resuscitative Thoracotomy ◽  
Aortic Balloon Occlusion ◽  
Torso Trauma ◽  
Endovascular Balloon Occlusion

Abstract Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used as an intra-aortic balloon occlusion method in Japan; however, the protocols for its effective use in different pathological conditions remain unclear. This study aimed to summarise the strategies of REBOA use in severe torso trauma.Methods: Twenty-nine cases of REBOA for torso trauma treated at our hospital over 5 years were divided into the shock (n=12), cardiopulmonary arrest (CPA) (n=13), and non-shock (n=4) groups. We retrospectively examined patient characteristics, trauma mechanism, injury site, severity score, intervention, survival rates at 24 hours, and intervention details in each group.Results: In the shock group, 9 and 3 patients survived and died within 24 hours, respectively; time to intervention (56.6 vs 130.7 min, p=0.346) and total occlusion time (40.2 vs 337.7 min, p=0.009) were both shorter in surviving patients than in the casualties. In the CPA group, 10 patients were converted from resuscitative thoracotomy with aortic cross-clamp (RTACC); a single patient survived. Four patients in the non-shock group survived, having received prophylactic REBOA.Conclusions: The efficacy of REBOA for severe torso trauma depends on patient condition. In the shock group, time to intervention and total occlusion time correlated with survival. The use of REBOA with definitive haemostasis and minimum delays to intervention may improve outcomes. Patients with CPA are at a high risk of mortality; however, conversion from RTACC may be effective in some cases. Prophylactic intervention in the non-shock group may help achieve immediate definitive haemostasis.

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in the Management of Trauma Patients: A Systematic Literature Review

2019 ◽  
Vol 85 (6) ◽  
pp. 654-662 ◽  
Author(s):  
Patrizio Petrone ◽  
Aida PÉRez-JimÉNez ◽  
Martín Rodríguez-Perdomo ◽  
Collin E. M. Brathwaite ◽  
D'andrea K. Joseph
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Single Case ◽  
Case Reports ◽  
Balloon Occlusion ◽  
Definitive Treatment ◽  
Trauma Patients ◽  
Aortic Balloon Occlusion ◽  
Number Of Patients ◽  
Endovascular Balloon Occlusion

Resuscitative endovascular balloon occlusion of the aorta (REBOA) represents an innovative method by which noncompressible bleeding in the torso can be mitigated until definitive treatment can be obtained. To perform a systematic review of the literature on the use of the REBOA in trauma patients. An English and Spanish literature search was performed using MEDLINE, PubMed, and Scopus, from 1948 to 2018. Keywords used were aortic balloon occlusion, resuscitative endovascular balloon, REBOA, hemorrhage, and resuscitative endovascular balloon occlusion of the aorta. The eligilibility criteria included only original and human subject articles. Nontrauma patients, nonbleeding pathology, letters, single case reports, reviews, and pediatric patients were excluded. Two hundred forty-six articles were identified, of which 17 articles were included in this review. The total number of patients was 1340; 69 per cent were men and 31 per cent women. In 465 patients, the aortic zone location was described: 83 per cent the balloon was placed in aortic zone I and 16 per cent in zone III. Systolic blood pressure increased at an average of 52 mmHg before and after aortic occlusion. Although 32 patients (2.4%) presented clinical complications derived from the procedure, no mortality was reported. The trauma-related mortality rate was 58 per cent (776/1340). REBOA is a useful resource for the management of non-compressive torso hemorrhage with promising results in systolic blood pressure and morbidity. Indications for its use include injuries in zones 1 and 3, whereas it is not clear for zone 2 injuries. Additional studies are needed to define the benefits of this procedure.

Intra-aortic balloon occlusion without fluoroscopy for life-threating post-partum hemorrhage

2016 ◽  
Vol 5 (1) ◽  
pp. 19-22
Author(s):  
Yuka Yamashita ◽  
Akihiro Kawashima ◽  
Junichi Hasegawa ◽  
Tomohiro Oba ◽  
Masamitsu Nakamura ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Post Partum ◽  
Balloon Occlusion ◽  
Post Partum Hemorrhage ◽  
Radical Treatment ◽  
Aortic Balloon Occlusion ◽  
Life Threatening ◽  
Endovascular Balloon Occlusion

Abstract The use of intra-aortic balloon occlusion (IABO) could be effective in achieving the quick control of bleeding in emergency settings and in supporting the provision of safe radical treatment through resuscitative endovascular balloon occlusion of the aorta (REBOA). We herein report our experience of a patient with life-threatening postpartum hemorrhage after cesarean section who was successfully treated by hysterectomy with IABO without fluoroscopy. We believe that this procedure is very useful and safe, and that it should be considered as one of methods for controlling bleeding in patients with life-threatening postpartum hemorrhage.

scholarly journals Intermittent use of resuscitative endovascular balloon occlusion of the aorta in penetrating gunshot wound of the lower extremity

2019 ◽  
Vol 62 (6) ◽  
pp. E9-E12
Author(s):  
Omar Bekdache ◽  
Tiffany Paradis ◽  
David Bracco ◽  
Aly Elbahrawy ◽  
Kosar Khwaja ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Gunshot Wound ◽  
Balloon Occlusion ◽  
Endovascular Balloon Occlusion

Use of Resuscitative Endovascular Balloon Occlusion of the Aorta in a Multidisciplinary Approach

2017 ◽  
Vol 12 (4) ◽  
pp. e1-e2 ◽  
Author(s):  
Carolina Nilsson ◽  
Linda Bilos ◽  
Tal Hörer ◽  
Artai Pirouzram
Keyword(s):  
Multidisciplinary Approach ◽  
Damage Control ◽  
Damage Control Surgery ◽  
Balloon Occlusion ◽  
Definitive Treatment ◽  
Bleeding Management ◽  
Aortic Balloon Occlusion ◽  
Trauma Case ◽  
Management Concept ◽  
Endovascular Balloon Occlusion

The usage of resuscitative endovascular balloon occlusion of the aorta, also known as aortic balloon occlusion, is an emerging method for bleeding control as a bridge to definitive treatment in trauma management. We describe a trauma case where resuscitative endovascular balloon occlusion of the aorta was used as part of the EndoVascular hybrid Trauma and bleeding Management concept to facilitate transient hemorrhage control and thereby to permit damage control surgery. The case is an illustration of the adoption of a multidisciplinary approach.

scholarly journals P042: Resuscitative endovascular balloon occlusion of the aorta (REBOA) in trauma: a systematic review

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S71-S72
Author(s):  
A. Eksteen ◽  
J. Odenbach ◽  
C. Archer ◽  
C. Domke
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Case Reports ◽  
Case Series ◽  
Weighted Average ◽  
Injured Patient ◽  
Severe Trauma ◽  
Balloon Occlusion ◽  
Aortic Balloon Occlusion ◽  
Endovascular Balloon Occlusion

Introduction: Trauma leading to uncontrolled hemorrhage of the torso in the critically injured patient can rapidly progress to decreased cerebral and cardiovascular perfusion and carries a significant morbidity and mortality. Given the non-compressible nature and difficult anatomic access of these injuries, obtaining hemostasis is often a challenge and non-surgical options are sparse. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is a rapidly administered emergency department intervention that allows transient source control of caudal torso hemorrhage while arranging definitive surgical management. Although initially postulated in the 1950s, limited research regarding its therapeutic use in trauma has been available until recently. Here, we present a systematic review of the literature pertaining to the use of REBOA in severe trauma. Methods: An experienced medical librarian searched electronic databases for terms relating to REBOA, aortic balloon occlusion, hemorrhage, trauma and shock. Articles were identified, screened, retrieved and reviewed in accordance with PRISMA systematic review guidelines. English case reports, case series, cohort studies, randomized-controlled trials, systematic reviews and meta-analyses pertaining to the use of REBOA in human trauma patients were included. Customized inclusion and data extraction forms were created and used to form an electronic database of relevant studies. Results: After exclusion of duplicates, 2147 potentially relevant articles were identified and screened by title/abstract and 136 articles meeting inclusion criteria were retrieved for full-text review. Final analysis of 26 articles included 5 case reports, 13 case series, 7 observational cohort studies and 1 systematic review. Data spanning 771 patients undergoing REBOA were collected (weighted average age: 49.5, gender: 67.7% male, injury severity score: 35.1). Where data available, REBOA increased systolic blood pressure by a weighted average of 54.7mmhg and overall survival was 32.6%. Conclusion: Limited evidence pertaining to the use of REBOA in severe trauma exists with the majority of available data coming from individual case studies and case series. By extension, quantitative analysis regarding outcome data of this intervention requires further research in the form of larger studies with subgroup analysis to identify the subset of patients for which REBOA may benefit and to further delineate the risks of implementing this intervention

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.

Sign in / Sign up

Export Citation Format

Share Document