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Exclusive clinical experience with a lower profile device for resuscitative endovascular balloon occlusion of the aorta (REBOA)

A lower profile, FDA-approved device for aortic occlusion (AO) is available for REBOA. Patients who received AO with the new device from February 2016 to February 2017 at 2 urban tertiary care centers were enrolled. 60 consecutive patients underwent REBOA; 44 (73.3%) following blunt trauma. 52 (88.1... Full description

Journal Title: The American journal of surgery 2019-06, Vol.217 (6), p.1126-1129
Main Author: Brenner, Megan
Other Authors: Moore, Laura , Teeter, William , Hu, Peter , Yang, Shiming , Wasicek, Philip , Taylor, John , Harvin, John , Stein, Deborah , Scalea, Thomas
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: United States: Elsevier Inc
ID: ISSN: 0002-9610
Link: https://www.ncbi.nlm.nih.gov/pubmed/30579686
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title: Exclusive clinical experience with a lower profile device for resuscitative endovascular balloon occlusion of the aorta (REBOA)
format: Article
creator:
  • Brenner, Megan
  • Moore, Laura
  • Teeter, William
  • Hu, Peter
  • Yang, Shiming
  • Wasicek, Philip
  • Taylor, John
  • Harvin, John
  • Stein, Deborah
  • Scalea, Thomas
subjects:
  • Abridged Index Medicus
  • Adult
  • Aged
  • Amputation
  • Aorta
  • Aortic occlusion (AO)
  • Balloon Occlusion - instrumentation
  • Balloon Occlusion - methods
  • Blood pressure
  • Cardiovascular system
  • Catheters
  • Complications
  • Coronary vessels
  • Emergency medical services
  • Endovascular Procedures - instrumentation
  • Endovascular Procedures - methods
  • Extremities
  • Female
  • Femoral artery
  • Femur
  • Hemorrhage
  • Hemorrhage - etiology
  • Hemorrhage - mortality
  • Hemorrhage - therapy
  • Humans
  • Hypotension
  • Implants
  • Ischemia
  • Male
  • Medical colleges
  • Middle Aged
  • Occlusion
  • Patients
  • Prospective Studies
  • Resuscitation - instrumentation
  • Resuscitation - methods
  • Resuscitative endovascular balloon occlusion of the aorta (REBOA)
  • Salvage
  • Sheaths
  • Single-Blind Method
  • Surgical implants
  • Survival
  • Trauma
  • Treatment Outcome
  • Veins & arteries
  • Wounds and Injuries - complications
  • Wounds and Injuries - mortality
  • Wounds and Injuries - therapy
ispartof: The American journal of surgery, 2019-06, Vol.217 (6), p.1126-1129
description: A lower profile, FDA-approved device for aortic occlusion (AO) is available for REBOA. Patients who received AO with the new device from February 2016 to February 2017 at 2 urban tertiary care centers were enrolled. 60 consecutive patients underwent REBOA; 44 (73.3%) following blunt trauma. 52 (88.1%) were male; mean age of 40 ± 18 years. 49 REBOAs were deployed in Zone 1, 11 in Zone 3.67.7% of patients in arrest achieved return of spontaneous circulation (ROSC). Overall in-hospital survival was 43%; 19% for patients in arrest and 69% for patients with refractory hypotension. Access and vascular procedural complications included iliac intimal injury requiring stent-graft (1), patch angioplasty of the CFA (1), and balloon ruptures (3). 5 amputations were required; 2 immediate completion amputations due to initial injury, and 3 delayed amputations after efforts to salvage severely mangled extremities were unsuccessful. Smaller introducer sheaths for REBOA are safe and effective but do not eliminate the need for surgical common femoral artery access. Patients can benefit from REBOA with acceptable survival rates. •Percutaneous CFA access results in more rapid AO than open cannulation.•Smaller introducers for REBOA do not eliminate the need for surgical arterial access .•Limb and life threatening complications can occur with the use of REBOA.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0002-9610
fulltext: fulltext
issn:
  • 0002-9610
  • 1879-1883
url: Link


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titleExclusive clinical experience with a lower profile device for resuscitative endovascular balloon occlusion of the aorta (REBOA)
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creatorBrenner, Megan ; Moore, Laura ; Teeter, William ; Hu, Peter ; Yang, Shiming ; Wasicek, Philip ; Taylor, John ; Harvin, John ; Stein, Deborah ; Scalea, Thomas
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descriptionA lower profile, FDA-approved device for aortic occlusion (AO) is available for REBOA. Patients who received AO with the new device from February 2016 to February 2017 at 2 urban tertiary care centers were enrolled. 60 consecutive patients underwent REBOA; 44 (73.3%) following blunt trauma. 52 (88.1%) were male; mean age of 40 ± 18 years. 49 REBOAs were deployed in Zone 1, 11 in Zone 3.67.7% of patients in arrest achieved return of spontaneous circulation (ROSC). Overall in-hospital survival was 43%; 19% for patients in arrest and 69% for patients with refractory hypotension. Access and vascular procedural complications included iliac intimal injury requiring stent-graft (1), patch angioplasty of the CFA (1), and balloon ruptures (3). 5 amputations were required; 2 immediate completion amputations due to initial injury, and 3 delayed amputations after efforts to salvage severely mangled extremities were unsuccessful. Smaller introducer sheaths for REBOA are safe and effective but do not eliminate the need for surgical common femoral artery access. Patients can benefit from REBOA with acceptable survival rates. •Percutaneous CFA access results in more rapid AO than open cannulation.•Smaller introducers for REBOA do not eliminate the need for surgical arterial access .•Limb and life threatening complications can occur with the use of REBOA.
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3PMID: 30579686
languageeng
publisherUnited States: Elsevier Inc
subjectAbridged Index Medicus ; Adult ; Aged ; Amputation ; Aorta ; Aortic occlusion (AO) ; Balloon Occlusion - instrumentation ; Balloon Occlusion - methods ; Blood pressure ; Cardiovascular system ; Catheters ; Complications ; Coronary vessels ; Emergency medical services ; Endovascular Procedures - instrumentation ; Endovascular Procedures - methods ; Extremities ; Female ; Femoral artery ; Femur ; Hemorrhage ; Hemorrhage - etiology ; Hemorrhage - mortality ; Hemorrhage - therapy ; Humans ; Hypotension ; Implants ; Ischemia ; Male ; Medical colleges ; Middle Aged ; Occlusion ; Patients ; Prospective Studies ; Resuscitation - instrumentation ; Resuscitation - methods ; Resuscitative endovascular balloon occlusion of the aorta (REBOA) ; Salvage ; Sheaths ; Single-Blind Method ; Surgical implants ; Survival ; Trauma ; Treatment Outcome ; Veins & arteries ; Wounds and Injuries - complications ; Wounds and Injuries - mortality ; Wounds and Injuries - therapy
ispartofThe American journal of surgery, 2019-06, Vol.217 (6), p.1126-1129
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9Scalea, Thomas
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descriptionA lower profile, FDA-approved device for aortic occlusion (AO) is available for REBOA. Patients who received AO with the new device from February 2016 to February 2017 at 2 urban tertiary care centers were enrolled. 60 consecutive patients underwent REBOA; 44 (73.3%) following blunt trauma. 52 (88.1%) were male; mean age of 40 ± 18 years. 49 REBOAs were deployed in Zone 1, 11 in Zone 3.67.7% of patients in arrest achieved return of spontaneous circulation (ROSC). Overall in-hospital survival was 43%; 19% for patients in arrest and 69% for patients with refractory hypotension. Access and vascular procedural complications included iliac intimal injury requiring stent-graft (1), patch angioplasty of the CFA (1), and balloon ruptures (3). 5 amputations were required; 2 immediate completion amputations due to initial injury, and 3 delayed amputations after efforts to salvage severely mangled extremities were unsuccessful. Smaller introducer sheaths for REBOA are safe and effective but do not eliminate the need for surgical common femoral artery access. Patients can benefit from REBOA with acceptable survival rates. •Percutaneous CFA access results in more rapid AO than open cannulation.•Smaller introducers for REBOA do not eliminate the need for surgical arterial access .•Limb and life threatening complications can occur with the use of REBOA.
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42Trauma
43Treatment Outcome
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45Wounds and Injuries - complications
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47Wounds and Injuries - therapy
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titleExclusive clinical experience with a lower profile device for resuscitative endovascular balloon occlusion of the aorta (REBOA)
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0Brenner, Megan
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atitleExclusive clinical experience with a lower profile device for resuscitative endovascular balloon occlusion of the aorta (REBOA)
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pages1126-1129
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abstractA lower profile, FDA-approved device for aortic occlusion (AO) is available for REBOA. Patients who received AO with the new device from February 2016 to February 2017 at 2 urban tertiary care centers were enrolled. 60 consecutive patients underwent REBOA; 44 (73.3%) following blunt trauma. 52 (88.1%) were male; mean age of 40 ± 18 years. 49 REBOAs were deployed in Zone 1, 11 in Zone 3.67.7% of patients in arrest achieved return of spontaneous circulation (ROSC). Overall in-hospital survival was 43%; 19% for patients in arrest and 69% for patients with refractory hypotension. Access and vascular procedural complications included iliac intimal injury requiring stent-graft (1), patch angioplasty of the CFA (1), and balloon ruptures (3). 5 amputations were required; 2 immediate completion amputations due to initial injury, and 3 delayed amputations after efforts to salvage severely mangled extremities were unsuccessful. Smaller introducer sheaths for REBOA are safe and effective but do not eliminate the need for surgical common femoral artery access. Patients can benefit from REBOA with acceptable survival rates. •Percutaneous CFA access results in more rapid AO than open cannulation.•Smaller introducers for REBOA do not eliminate the need for surgical arterial access .•Limb and life threatening complications can occur with the use of REBOA.
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doi10.1016/j.amjsurg.2018.11.029
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