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Ann Vasc Surg. 2018 Nov 27. pii: S0890-5096(18)30882-3. doi: 10.1016/j.avsg.2018.08.108. [Epub ahead of print]

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) not yet applicable for widespread out-of-hospital use: a Case of nonsurvivable complication from prolonged REBOA inflation.

Author information

1
Division of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD 21201 USA. Electronic address: jackie.m.zhang@gmail.com.
2
Division of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD 21201 USA.
3
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Emory University School of Medicine.

Abstract

BACKGROUND:

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is being considered for temporizing catastrophic hemorrhage prior to arriving at a specialty center for definitive surgical management.

CASE:

We describe the clinical case of a 72-year-old male with a ruptured infrarenal aortic abdominal aneurysm, initially stabilized with REBOA at an outside facility and transferred to our care. Transport time was >100 minutes. Despite successful surgical repair of the ruptured aneurysm, the patient expired from multiple organ failure likely related to ischemia-reperfusion injury from prolonged balloon occlusion of the aorta.

CONCLUSION:

Ischemia-mitigating techniques and therapies need to improve drastically before the clinical application of REBOA can be effectively extended to outside the vicinity of specialty centers.

PMID:
30500643
DOI:
10.1016/j.avsg.2018.08.108

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