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Partial REBOA

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Endovascular Resuscitation and Trauma Management

Part of the book series: Hot Topics in Acute Care Surgery and Trauma ((HTACST))

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Abstract

Partial resuscitative balloon occlusion of the aorta (P-REBOA) has emerged as an alternative technique to complete aortic occlusion (REBOA). As it is currently utilized, REBOA is a simple “all-or-none” phenomenon. The balloon is inflated causing exclusion of downstream tissue beds from blood flow. P-REBOA differs from REBOA in that it allows a limited amount of blood flow beyond the aortic occlusion balloon in order to mitigate the negative effects of complete aortic occlusion. P-REBOA is guided by the underlying concept that lowering the pressure and flow to a hemorrhaging tissue bed will allow clot to form around the source of hemorrhage. This clot formation, along with vasospasm, will minimize ongoing bleeding. Furthermore, the small amount of blood flow beyond the balloon may lessen the ischemic burden and allow aerobic metabolism within distal tissue beds, while simultaneously mitigating the supraphysiologic proximal blood pressures observed during conventional REBOA. This variation of REBOA may serve to extend the tolerable duration of intervention. This chapter will discuss the technique of P-REBOA including the physiology of partial aortic occlusion, translational and early clinical data of P-REBOA, as well as future considerations for continued refinement of the technique.

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Author information

Authors and Affiliations

  1. Department of Surgery, University of California Davis Medical Center, Sacramento, CA, USA

    Anders J. Davidson

  2. Vascular and Endovascular Surgery, Wake Forest Baptist Health, Winston-Salem, NC, USA

    Timothy K. Williams

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  1. Anders J. Davidson
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Editor information

Editors and Affiliations

  1. Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden

    Tal Hörer

  2. University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA

    Joseph J. DuBose

  3. F. Edward Hebert School of Medicine – “America’s Medical School”, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Todd E. Rasmussen

  4. The Department of Surgery at Uniformed Services, University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, MD, USA

    Joseph M. White

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Davidson, A.J., Williams, T.K. (2020). Partial REBOA. In: Hörer, T., DuBose, J., Rasmussen, T., White, J. (eds) Endovascular Resuscitation and Trauma Management . Hot Topics in Acute Care Surgery and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-030-25341-7_7

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  • DOI: https://doi.org/10.1007/978-3-030-25341-7_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-25340-0

  • Online ISBN: 978-3-030-25341-7

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