Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-nmvwc Total loading time: 0 Render date: 2024-07-04T20:36:30.617Z Has data issue: false hasContentIssue false

Chapter 24 - Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)

from Section 6 - Abdomen

Published online by Cambridge University Press:  21 October 2019

Demetrios Demetriades
Affiliation:
University of Southern California
Kenji Inaba
Affiliation:
University of Southern California
George Velmahos
Affiliation:
Massachusetts General Hospital, Boston
Get access

Summary

  • Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is a compliant, endovascular balloon designed to occlude the thoracic or lower abdominal aorta in hemorrhagic shock, for temporary control of bleeding in the abdomen or pelvis.

  • The REBOA catheter is placed through a sheath in the right or left common femoral artery, accessed using anatomic landmarks, ultrasound guidance, or with open surgical technique. The balloon is then inflated in the thoracic or abdominal aorta, effectively acting as a minimally invasive aortic cross-clamp.

  • The procedure for placing a REBOA takes only a few minutes.

  • REBOA is ideally suited for hypotensive patients with abdominal or pelvic bleeding and can be placed in the emergency room, intensive care unit, or the operating theater.

  • REBOA balloon placement can be guided and confirmed using external landmarks, X-ray, fluoroscopy, or ultrasound. Balloon inflation volumes are titrated based on invasive blood pressure monitoring, haptic feedback, and imaging.

  • REBOA is contraindicated in patients with intrathoracic, neck, or facial bleeding, in cases with high suspicion for blunt thoracic aortic injury, and in patients in cardiac arrest.

  • Aortic occlusion is a temporary, resuscitative measure and should be considered a transition to definitive care. After inflation, the patient should be immediately transported to the operating room or the interventional suite for definitive management of their traumatic injuries.

  • REBOA balloon inflation results in distal ischemia and as such, occlusion times should be minimized.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×