Safety and Effectiveness of Aortic Occlusion for Those Undergoing Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): A Retrospective Single-Center Study

J Emerg Med. 2022 May;62(5):607-616. doi: 10.1016/j.jemermed.2021.11.017. Epub 2022 Jan 31.

Abstract

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to temporarily control bleeding and maintain the cerebral and coronary blood flow in cases in which it is difficult to control hemorrhagic shock. However, the safety and effectiveness of REBOA remains uncertain.

Objectives: This study aimed to estimate the safety and effectiveness of aortic occlusion in patients who undergo REBOA catheter placement.

Methods: We conducted a retrospective study of patients who underwent REBOA catheter placement at Fukuyama City Hospital Emergency Medical Center from August 1, 2008 to March 31, 2020. A propensity score-matching analysis was used to compare 30-day survival between patients who undergo REBOA catheter placement with and without aortic occlusion.

Results: Overall, 122 of the 147 who underwent REBOA catheter placement at Fukuyama City Hospital were eligible for inclusion. Thirty-five patients in the Occlusion group and 35 patients in the Nonocclusion group were selected by propensity score matching. According to the 30-day survival rate, the difference between the two groups was not statistically significant (p = 0.288 log-rank test). Moreover, the required treatment, the types and incidence of complications, and other outcomes did not differ according to the presence or absence of aortic occlusion in patients who underwent REBOA catheter placement.

Conclusion: According to the results of this study, in trauma patients who undergo REBOA catheter placement, the presence of aortic occlusion was not significantly associated with 30-day mortality. Furthermore, the performance of aortic occlusion was not associated with a significant increase in complications.

Keywords: aortic occlusion; hemorrhagic shock; propensity score matching; resuscitative endovascular balloon occlusion of the aorta (REBOA).

MeSH terms

  • Aorta
  • Balloon Occlusion* / methods
  • Endovascular Procedures* / methods
  • Humans
  • Injury Severity Score
  • Resuscitation / methods
  • Retrospective Studies
  • Shock, Hemorrhagic* / etiology
  • Shock, Hemorrhagic* / therapy