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The resuscitative endovascular balloon occlusion of aorta (REBOA) device—what radiologists need to know

  • Linzi ArndtEmail author
  • Danial Mir
  • Johnathan Nguyen
  • Nariman Nezami
  • Sean R Dariushnia
  • Laura K. Findeiss
  • Adam Prater
  • Derek L. West
  • Bill S. Majdalany
  • Nima Kokabi
Pictorial Essay
  • 59 Downloads

Abstract

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a novel device approved by the Food and Drug administration (FDA) in 2017 as an alternative to resuscitative emergent thoracotomy (RET). Due to advancements in placement of REBOA, including newly validated placement using anatomic landmarks, REBOA is now widely used by interventional radiologists and emergency physicians in acute subdiaphragmatic hemorrhage. Increased use of REBOA necessitates that radiologists are familiar with verification of proper REBOA placement to minimize complications. This review describes the REBOA device, indications, placement, and complications, summarizing the current available literature.

Keywords

REBOA Trauma ER-REBOA Resuscitative endovascular balloon occlusion of the aorta 

Notes

Compliance with ethical standards

Conflict of interest

Author Dr. Jonathan Nguyen is a speaker for educational events by a maker of the REBOA device (Prytime).

All other authors declare they have no conflict of interest.

References

  1. 1.
    Curry N, Hopewell S, Dorée C, Hyde C, Brohi K, Stanworth S (2011) The acute management of trauma hemorrhage: a systematic review of randomized controlled trials. Crit Care 15(2):R92–R92CrossRefGoogle Scholar
  2. 2.
    Moore LJ, Brenner M, Kozar RA, Pasley J, Wade CE, Baraniuk MS, Scalea T, Holcomb JB (2015) Implementation of resuscitative endovascular balloon occlusion of the aorta as an alternative to resuscitative thoracotomy for noncompressible truncal hemorrhage. J Trauma Acute Care Surg 79(4):523–532CrossRefGoogle Scholar
  3. 3.
    Dutton RP, Stansbury LG, Leone S, Kramer E, Hess JR, Scalea TM (2010) Trauma mortality in mature trauma systems: are we doing better? An analysis of trauma mortality patterns, 1997–2008. J Trauma Acute Care Surg 69(3):620–626CrossRefGoogle Scholar
  4. 4.
    Anna Romagnoli M, Teeter W, Pasley J, Hu P, Hoehn M, Stein D, Scalea T, Brenner M (2016) Time to aortic occlusion: it’s all about access. J Trauma Acute Care Surg 83(6):1161–1164CrossRefGoogle Scholar
  5. 5.
    Brenner M et al (2018) Joint statement from the American College of Surgeons Committee on Trauma (ACS COT) and the American College of Emergency Physicians (ACEP) regarding the clinical use of resuscitative endovascular balloon occlusion of the aorta (REBOA). Trauma Surg Acute Care Open 3(1):e000154CrossRefGoogle Scholar
  6. 6.
    Aguel F (2017) 510(K) Summary, Food and Drug Administration: https://www.accessdata.fda.gov/cdrh_docs/pdf17/K170411.pdf. Accessed 26 Aug 2019
  7. 7.
    Stone PA, Campbell JE (2012) Complications related to femoral artery access for transcatheter procedures. Vasc Endovasc Surg 46(8):617–623CrossRefGoogle Scholar
  8. 8.
    Okada Y et al (2017) Anatomical landmarks for safely implementing resuscitative balloon occlusion of the aorta (REBOA) in zone 1 without fluoroscopy. Scand J Trauma Resusc Emerg Med 25(1):63CrossRefGoogle Scholar
  9. 9.
    Surucu HS et al (2003) Anatomy of the celiac trunk examined by CT imaging of 104 individuals. Morphologie 87(277):33–35Google Scholar
  10. 10.
    Uğur Özkan LO, Tercan F, Kızılkılıç O, Koç Z, Koca N (2006) Renal artery origins and variations: angiographic evaluation of 855 consecutive patients. Diagn Interv Radiol 12(4):183–186Google Scholar
  11. 11.
    Markov NP et al (2013) Physiologic tolerance of descending thoracic aortic balloon occlusion in a swine model of hemorrhagic shock. Surgery 153(6):848–856CrossRefGoogle Scholar
  12. 12.
    Sato R, Kuriyama A, Takaesu R, Miyamae N, Iwanaga W, Tokuda H, Umemura T (2018) Resuscitative endovascular balloon occlusion of the aorta performed by emergency physicians for traumatic hemorrhagic shock: a case series from Japanese emergency rooms. Crit Care 22(1):103CrossRefGoogle Scholar
  13. 13.
    Wasicek PJ et al (2018) Resuscitative endovascular balloon occlusion of the aorta: rupture risk and implications for blind inflation. Trauma Surg Acute Care Open 3(1):e000141CrossRefGoogle Scholar
  14. 14.
    Perkins ZB, Lendrum RA, Brohi K (2016) Resuscitative endovascular balloon occlusion of the aorta: promise, practice, and progress? Curr Opin Crit Care 22(6):563–571Google Scholar
  15. 15.
    Ordoñez CA et al (2017) Current use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in trauma. Colombia J Anesthesiol 45:30–38Google Scholar

Copyright information

© American Society of Emergency Radiology 2019

Authors and Affiliations

  • Linzi Arndt
    • 1
    Email author
  • Danial Mir
    • 2
  • Johnathan Nguyen
    • 3
  • Nariman Nezami
    • 4
  • Sean R Dariushnia
    • 2
  • Laura K. Findeiss
    • 2
  • Adam Prater
    • 2
  • Derek L. West
    • 2
  • Bill S. Majdalany
    • 2
  • Nima Kokabi
    • 2
  1. 1.Emory University School of MedicineAtlantaUSA
  2. 2.Emory University Department of Radiology and Imaging ServicesAtlantaUSA
  3. 3.Morehouse School of MedicineAtlantaUSA
  4. 4.Russell H Morgan Department of Radiology and Radiological ScienceJohns Hopkins MedicineBaltimoreUSA

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