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Resuscitative endovascular balloon occlusion of the aorta with a low profile wire free device: A game changer?

机译:具有低调无导线装置的主动脉复苏性血管内球囊闭塞:改变游戏规则?

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摘要

A 24 year old male arrived to our hospital after a motor cycle crash with evidence of a traumatic brain injury and in hemorrhagic shock not responsive to volume administration. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) was performed in a timely fashion using a new, low profile, wire free device. This lead to rapid reversal of hypotension while his bleeding source was sought and controlled.Recently, REBOA has emerged as an adjunct in the hypotensive trauma patient with noncompressible torso hemorrhage. As first described, this procedure makes use of commonly available vascular surgery and endovascular products requiring large introducer sheaths (12–14 French) and long guidewires. Concerns regarding this technique center around the safety and feasibility of using such equipment in the emergency setting outside an angiography suite. This has likely limited widespread adoption of this technique. To address these concerns, newer products designed to be placed through a smaller sheath (7 French) and without the use of guidewires have been developed. Here we report on our first clinical use of such a device that we believe represents a significant advance in the care of the trauma patient.
机译:一名摩托车事故发生后,一名24岁的男性到达我院,并有外伤性脑损伤和失血性休克的迹象,对大量给药没有反应。使用新型,低矮的,无电线的设备及时进行了可复苏的主动脉腔内血管球囊阻塞(REBOA)。在寻求和控制出血源的同时,这导致低血压的快速逆转。最近,REBOA已作为患有不可压缩的躯干出血的低血压创伤患者的辅助手段出现。如前所述,该程序利用了需要大的导引鞘管(12-14法国)和长导丝的常规血管外科手术和血管内产品。有关此技术的关注点集中在在血管造影套件外部的紧急情况下使用此类设备的安全性和可行性。这可能限制了该技术的广泛采用。为了解决这些问题,已经开发出了设计成通过较小的护套(7法式)放置且不使用导丝的较新产品。在这里,我们报告了这种设备的首次临床使用,我们认为这代表着在创伤患者护理方面的重大进步。

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