canadi EM - August 25, 2022 - By Braedon Paul
…Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)
Traditionally, resuscitative thoracotomy (RT) with aortic cross-clamping has been the intervention of choice for achieving control of non-compressible torso hemorrhage (NCTH) for patients in extremis (i.e., severe hemodynamic compromise). This is, of course, a temporizing measure until definitive surgical management can be obtained. Despite what the writers of Grey’s Anatomy or ER want us to think, survival rates following ED thoracotomy for penetrating abdominal trauma are somewhat disheartening (around 9% based on 25 years of data from 2000).
In more recent literature, resuscitative endovascular balloon occlusion of the aorta (REBOA – not to be confused with country music sensation, Reba) has been suggested as an alternative to RT for achieving NCTH control for life-threatening bleeds. As the name suggests, REBOA involves deploying an occluding balloon in the distal thoracic or distal abdominal aorta (depending on the site of injury), typically via the femoral artery, to gain hemorrhage control and thus improve proximal perfusion to the brain and coronaries...
A video demonstrating this technique with the ER-REBOA catheter system can be viewed here: ER-REBOA™ Procedure – YouTube