Emergency Medicine Book

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Resuscitative Endovascular Balloon Occlusion of the Aorta

Aka: Resuscitative Endovascular Balloon Occlusion of the Aorta, REBOA
  1. Indications
    1. Severe Pelvic Fractures who have not had Cardiac Arrest who need immediate temporizing measures
      1. May be considered in Peri-Arrest patient without obvious source of Hemorrhage
      2. Best used for short-term bridging to definitive procedure (risk of distal ischemia)
  2. Technique
    1. Percutaneous balloon delivered via groin catheter and inflated in aorta above level of Hemorrhage
    2. Performed in 5-10 minutes in skilled hands
  3. Efficacy
    1. Studies in 2016, suggest lower efficacy than initially thought, and may be associated with higher mortality
      1. Inoue (2016) J Trauma Acute Care Surg 80(4): 559-67 +PMID: 26808039 [PubMed]
  4. Complications
    1. Aortic Dissection
    2. Suprarenal Occlusion (balloon too high)
    3. Distal Thromboembolism
  5. Resources
    1. HQMedEd (Glenn Paetow)
      1. http://hqmeded.com/resuscitative-endovascular-balloon-occlusion-aorta-reboa/
  6. References
    1. Inaba in Herbert (2013) EM:Rap 13(11): 3-4
    2. Hughes (1954) Surgery 36(1):65-8 [PubMed]

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