Resuscitative endovascular balloon occlusion of the aorta

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a recently developed treatment for haemorrhagic shock used in major trauma patients with life-threatening abdominal or lower limb bleeding. 

The aortic balloon is delivered on a catheter via the femoral artery in order to reduce any distal bleeding and raise blood pressure in order to buy time for definitive surgical haemostasis. It has been used both in the pre-hospital and emergency room setting in a small number of trauma patients but high-quality data on its efficacy remains lacking 1.

Potentially used in selected adult patients aged 18-69 years with suspected of confirmed internal haemorrhage below the level of the diaphragm:

  • in haemorrhagic shock unresponsive or transiently responsive to resuscitation
  • in PEA arrest < 10 minutes
  • age > 70 years
  • pre-existing terminal illness or significant co-morbidity
  • high suspicion of proximal traumatic aortic dissection
  • groin vessels not immediately identifiable on ultrasound
  • PEA arrest > 10 minutes
  • cardiac arrest from other causes than exsanguination
  • significant non-compressible haemorrhage above the diaphragm
    • superior mediastinum
    • axilla
    • face or neck

There is a reported 4-5% incidence of arterial puncture related complications from the procedure 3.

Mortality in these patients remains high at between 34-64% with a lack of high-quality data for the effectiveness of REBOA 4.

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Article information

rID: 60750
Tag: refs, cases
Synonyms or Alternate Spellings:
  • REBOA

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