Control of Blood Loss During Sacral Surgery by Aortic Balloon Occlusion

2007 ◽  
Vol 105 (3) ◽  
pp. 700-703 ◽  
Author(s):  
Lan Zhang ◽  
Quan Gong ◽  
Hong Xiao ◽  
Chongqi Tu ◽  
Jin Liu
2018 ◽  
Vol 476 (3) ◽  
pp. 490-498 ◽  
Author(s):  
Yidan Zhang ◽  
Wei Guo ◽  
Xiaodong Tang ◽  
Rongli Yang ◽  
Taiqiang Yan ◽  
...  

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Baoju Zhu ◽  
Kaili Yang ◽  
Lina Cai

Objective. This paper is aimed at investigating the role and value of the timing of balloon occlusion of the abdominal aorta during caesarean section in patients with pernicious placenta previa complicated with placenta accreta. Methods. 79 cases admitted to the Second Affiliated Hospital of Zhengzhou University from September 2015 to December 2016 were treated with ultrasound mediated abdominal aortic balloon occlusion. Among them, 42 cases, whose balloon occlusion time was selected before the delivery and transverse incision was taken, were group A. The other 37 cases were group B, whose timing of balloon occlusion was selected after the delivery and the uterine incision made trying to avoid the placenta or double incisions. The intraoperative blood loss, utilization of blood, and other indicators were compared between the two groups. Results. The intraoperative blood loss in groups A and B was 413.8 ± 105.9 ml and 810.3 ± 180.3 ml, and the utilization of blood products in groups A and B was 30.23% and 89.2%. The total hysterectomy rate was 2.53% (2/79), with no hysterectomies in groups A and 2 cases in group B. Conclusion. The balloon occlusion of the abdominal aorta before the delivery combined with a transverse incision is more effective.


2010 ◽  
Vol 92 (8) ◽  
pp. 1747-1753 ◽  
Author(s):  
Xiaodong Tang ◽  
Wei Guo ◽  
Rongli Yang ◽  
Shun Tang ◽  
Sen Dong

2019 ◽  
Author(s):  
Zhongmei Yang ◽  
Jie Mei ◽  
Yan Hou ◽  
Qinyin Deng ◽  
Mengwei Huang ◽  
...  

Abstract Background Placenta increta or percreta will result in severe postpartum hemorrhage and become a research hotspot in obstetrics. Preoperative abdominal aortic balloon occlusion (AABO), as a new intravascular interventional therapy, has taken more and more attention in obstetrics. Thus, the aim of this study is to evaluate the safety and efficacy of abdominal aortic balloon occlusion. Methods Retrospective analysis of pregnant women with placenta increta or percreta delivered between January 2013 and April 2019 in the Sichuan Provincial People’s Hospital. The experimental group (AABO group) included 168 patients who underwent abdominal aortic balloon occlusion before cesarean section. The control group (NO-AABO group) was composed of 106 patients who underwent surgery without any preoperative intravascular interventional therapy. The parameters containing estimated blood loss, red cell suspension (RCS) transfusion volume, hysterectomy, surgery time, postoperative hospital days, neonatal status and complications were compared between the two groups. Results The patients with preoperative abdominal aortic balloon occlusion had significant reduction in blood loss volume, red cell suspension transfusion volume and plasma transfusion volume compared to patients without balloon. Similarly, the surgery time and hysterectomy were obviously reduced in AABO group. However, there were no differences in the Apgar scores and neonatal complications between the two groups, indicating that the abdominal aortic balloon has little adverse effect on the newborns. Conclusion AABO is a safe and effective technology for pregnant women with placenta increta or percreta to reduce blood loss volume and blood transfusion volume.


Author(s):  
Igor M. Samokhvalov

Dear Readers, Welcome to the sixth edition of the JEVTM! In 1866, the Great Russian surgeon and scientist Nikolai Pirogov wrote: “A new era for surgery will begin, if we can quickly and surely control the flow in a major artery without exploration and ligation”. This era has now arrived and it is called EVTM! Our mission has been to maximize the benefits of endovascular technologies for trauma and bleeding patients: from the first attempts of REBOA by Carl Hughes in the 1950s with hand-made aortic balloon occlusion catheters used in our department since the early 1990s to modern successful cases of out-of-hospital REBOA use in combat and civilian casualties for ruptured aneurysms, post-partum hemorrhage and trauma. In this edition, you will find articles related to a new strategy of damage control interventional radiology (DCIR), partial REBOA in elderly patients and in ruptured aortic aneurysms, thrombolysis for trauma-associated IVC thrombosis, simulation models for training of REBOA, contemporary utilization of Zone III REBOA and more. As a continuation of EVTM development, Russian surgeons, emergency physicians, anesthetists, and others will be involved in the world of EVTM, participating in expanding the horizons of trauma care and cultivating the endovascular mindset. Also published in this edition are some of the abstracts that will be presented at the EVTM conference in Russia, St. Petersburg (7/06/2019). More than 35 oral and 30 poster presentations will make this conference a scientific feast for our audience! By adopting these new techniques for bleeding management, we are following Pirogov’s motto – to achieve fast endovascular hemorrhage control – which can only be done as part of an interdisciplinary approach.   We look forward to seeing you in Saint Petersburg at the EVTM-Russia meeting! www.evtm.org


2021 ◽  
Author(s):  
Luchen Wang ◽  
Yunfeng Li ◽  
Yaojun Dun ◽  
Xiaogang Sun

Abstract Background: Total aortic arch replacement (TAR) with frozen elephant trunk (FET) requires hypothermic circulatory arrest (HCA) for 20 minutes, which increases the surgical risk. We invented an aortic balloon occlusion technique that requires 5 minutes of HCA on average to perform TAR with FET and investigated the possible merit of this new method in this study. Methods: This retrospective study included consecutive patients who underwent TAR and FET (consisting of 130 cases of aortic balloon occlusion group and 230 cases of conventional group) in Fuwai Hospital between August 2017 and February 2019. In addition to the postoperative complications, the alterations of blood routine tests, alanine transaminase (ALT) and aspartate transaminase (AST) during the in-hospital stay were also recorded. Results: The 30-day mortality rates were similar between the aortic balloon occlusion group (4.6%) and the conventional group (7.8%, P = 0.241). Multivariate analysis showed aortic balloon occlusion reduced postoperative acute kidney injury (23.1% vs 35.7%, P = 0.013) and hepatic injury (12.3% vs 27.8%, P = 0.001), and maintained similar cost to patients (25.5 vs 24.9 kUSD, P = 0.298). We also found that AST was high during intensive care unit (ICU) stay and recovered to normal before discharge, while ALT was not as high as AST in ICU but showed a rising tendency before discharge. The platelet count showed a rising tendency on postoperative day 3 and may exceed the preoperative value before discharge. Conclusions: The aortic balloon occlusion achieved the surgical goal of TAR with FET with an improved recovery process during the in-hospital stay.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Tomohiko Orita ◽  
Tomohiro Funabiki ◽  
Motoyasu Yamazaki ◽  
Masayuki Shimizu ◽  
Tomohiro Sato ◽  
...  

Introduction: Fluid resuscitation (FR) and massive transfusion protocol (MTP) are important initial strategies for traumatic hemorrhagic shock cases. But poor responded patients to them are difficult to rescue. In such cases, open aortic cross clamping or intra-aortic balloon occlusion (IABO) would be performed as a temporary hemostasis treatment. Recently, IABO for severe trauma has been named resuscitative endovascular balloon occlusion of the aorta (REBOA). But it is still unclear which case can be rescued with REBOA. So we studied the relationship between the responsiveness to FR and REBOA. Methods: Consecutive 46 traumatic hemorrhagic shock patients underwent REBOA at our ER for last 86 months were included. All of their FAST were positive and done FR and MTP as a first-line resuscitation. 10Fr or 7Fr IABO devices were inserted at supraphrenic level (zone I) and underwent fundamental hemostasis by operative management (OM) and/or transcatheter arterial embolization (TAE). They were sorted into responded group or non-responded group for REBOA. The primary end point was a recovery rate from the shock state within 48 hours. Secondary end points were a survival rate in 30th days and a rate of complications. Results: 26 transient or non-responded patients (Fluid Non-responder) responded for REBOA (REBOA Responder group). 20 Fluid Non-responders did not respond for REBOA (REBOA Non-responder group). There were no significant differences in ISS (REBOA Responder vs. Non-responder: 45.8+/-15.2 vs. 54.8+/-22.3), amount of total fluid (7187+/-5782ml vs. 6772+/-4851) and total blood transfusion (4816+/-3006ml vs. 5080+/-3330), required time to occlude after arriving ER (25.3+/-12.6min vs. 19.4+/-9.8) and total occlusion time (76.4+/-66.5min vs. 92.7+/-34.4). There was significant difference in the changes of systolic blood pressure before and after of REBOA (59.3+/-25.7mmHg vs. 38.3+/-39.4, p=0.04). A recovery rate from shock state was 65%(12/26) vs. 0%(0/20) (p<0.01) and a survival rate was 14/26(54%) vs. 0/20(0%) (p<0.01). One complication occurred in REBOA Responder group but was not lethal. Conclusions: It would be necessary to recognize that Fluid Non-responder but REBOA Responder with traumatic hemorrhagic shock could be possible to rescue.


HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S835
Author(s):  
G. Singh ◽  
J. Samra ◽  
S. Wong ◽  
C. Thoo ◽  
A. Mittal ◽  
...  

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