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J Trauma Acute Care Surg. 2018 Jan;84(1):192-202. doi: 10.1097/TA.0000000000001711.

The pitfalls of resuscitative endovascular balloon occlusion of the aorta: Risk factors and mitigation strategies.

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From the University of California Davis (A.J.D., R.M.R., J.J.D.), Sacramento, California; Kirov Military Medical Academy (V.A.R.), Saint-Petersburg, Russian Federation; R Adams Cowley Shock Trauma Medical Center (M.L.B.), Baltimore, Maryland; University of Texas Health Science Center (L.J.M.), Houston, Texas; Foothills Medical Centre (C.B.), University of Calgary, Calgary, Alberta, Canada; Harborview Medical Center (E.B.), University of Washington, Seattle, Washington; Denver Health (E.E.M.), Denver, Colorado; Uniformed Services (T.E.R.), University of the Health Sciences, Bethesda, Maryland.


Despite technological advancements, REBOA is associated with significant risks due to complications of vascular access and ischemia-reperfusion. The inherent morbidity and mortality of REBOA is often compounded by coexisting injury and hemorrhagic shock. Additionally, the potential for REBOA-related injuries is exaggerated due to the growing number of interventions being performed by providers who have limited experience in endovascular techniques, inadequate resources, minimal training in the technique, and who are performing this maneuver in emergency situations. In an effort to ultimately improve outcomes with REBOA, we sought to compile a list of complications that may be encountered during REBOA usage. To address the current knowledge gap, we assembled a list of anecdotal complications from high-volume REBOA users internationally. More importantly, through a consensus model, we identify contributory factors that may lead to complications and deliberate on how to recognize, mitigate, and manage such events. An understanding of the pitfalls of REBOA and strategies to mitigate their occurrence is of vital importance to optimize patient outcomes.

[Indexed for MEDLINE]

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