Implementation of resuscitative endovascular balloon occlusion of the aorta at the Korean Regional Trauma Center

Abstract

Background: Resuscitative endovascular balloon occlusion of the aorta is used as adjunctive management for a profound shock in some trauma centers. We report our early experience of resuscitative endovascular balloon occlusion of the aorta to describe the implementation and possible indications of resuscitative endovascular balloon occlusion of the aorta. Objective: This study was designed to investigate the feasibility and effectiveness of resuscitative endovascular balloon occlusion of the aorta based on our experience and share our implementation process by trauma surgeons in Korea. Methods: We performed a retrospective review of consecutive cases of resuscitative endovascular balloon occlusion of the aorta in profound shock due to noncompressible torso hemorrhage at a single Korean trauma center. Resuscitative endovascular balloon occlusion of the aorta was introduced and implemented with written protocol and endovascular training courses. Results: All cases (n = 24) were done for blunt mechanisms. Twelve cases (50%) were resuscitative endovascular balloon occlusion of the aorta in zone I, three cases (12.5%) were zone II, and nine cases (45%) in zone III. Mean pre-occlusion systolic blood pressure was 47 mm Hg and mean systolic blood pressure increase was 41.3 mm Hg. Twenty-one patients (87.5%) survived at trauma bay and seven patients (29.2%) survived and discharged without neurologic deficit. There were two complications directly related to the procedure. Conclusion: Resuscitative endovascular balloon occlusion of the aorta is a useful adjunctive skill for trauma surgeons, and a brief training course can help in the implementation of the procedure.