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European Journal of Trauma and Emergency Surgery

Published in:

01-02-2021 | Review Article

A contemporary assessment of devices for Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): resource-specific options per level of care

Authors: Suzanne M. Vrancken, Boudewijn L. S. Borger van der Burg, Paul J. E. M. Vrancken, Gert-Aldert H. Kock, Todd E. Rasmussen, Rigo Hoencamp

Published in: European Journal of Trauma and Emergency Surgery | Issue 1/2021

Abstract

Purpose

Use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) as adjunct for temporary hemorrhage control in patients with exsanguinating torso hemorrhage is increasing. Characteristics of aortic occlusion balloons (AOB) are diverse and evolving as efforts are made to improve the technology. It is important to select a device that fits the requirements of the medical situation to minimize the risk of failure and complications. The aim of this study is to appraise guidance in the choice of an AOB in a specific situation.

Methods

We assessed 29 AOB for differences and outline possible advantages and disadvantages of each. Bending stiffness was measured with a three-point bending device.

Results

Diameter of the AOB ranged from 6 (ER-REBOA™) to 10 (Coda^®-46) French. However, some need large-bore access sheaths up to 22 French (Fogarty^®-45 and LeMaitre^®-45) or even insertion via cut-down (Equalizer™-40). Bending stiffness varied from 0.08 N/mm (± 0.008 SD; Coda^®-32) to 0.72 N/mm (± 0.024 SD; Russian prototype). Rescue Balloon™ showed kinking of the shaft at low bending pressures. The only non-compliant AOB is REBOA Balloon^®. ER-REBOA™, Fogarty^®, LeMaitre^®, REBOA Balloon^®, and Rescue Balloon™ are provided with external length marks to assist blind positioning.

Conclusion

In resource-limited settings, a guidewire- and fluoroscopy-free, rather stiff device, such as ER-REBOA™, Fogarty^®, and LeMaitre^®, is warranted. Of these devices, ER-REBOA™ is the only catheter compatible with seven French sheaths and specifically designed for emergency hemorrhage control. Of the over-the-wire devices, Q50^® has several features that facilitate use and reduce the risk of malplacement or vessel damage.

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Title: A contemporary assessment of devices for Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): resource-specific options per level of care
Authors: Suzanne M. Vrancken
Boudewijn L. S. Borger van der Burg
Paul J. E. M. Vrancken
Gert-Aldert H. Kock
Todd E. Rasmussen
Rigo Hoencamp
Publication date: 01-02-2021
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 1/2021
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-020-01382-5

At a glance: The STEP trials

Springer Medicine

A contemporary assessment of devices for Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): resource-specific options per level of care

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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