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A small case series of aortic balloon occlusion in trauma: lessons learned from its use in ruptured abdominal aortic aneurysms and a brief review
Örebro University, School of Medical Sciences. Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro University, Örebro, Sweden.
Örebro University, School of Health Sciences. Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro University, Örebro, Sweden.ORCID iD: 0000-0003-0934-0063
Örebro University, School of Medical Sciences. Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro University, Örebro, Sweden.
Örebro University, School of Medical Sciences. Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro University, Örebro, Sweden.
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2016 (English)In: European Journal of Trauma and Emergency Surgery, ISSN 1863-9933, E-ISSN 1863-9941, Vol. 42, no 5, 585-592 p.Article, review/survey (Refereed) Published
Abstract [en]

EndoVascular and Hybrid Trauma Management (EVTM) is an emerging concept for the early treatment of trauma patients using aortic balloon occlusion (ABO), embolization agents and stent grafts to stop ongoing traumatic bleeding. These techniques have previously been implemented successfully in the treatment of ruptured aortic aneurysm.

We describe our very recent experience of EVTM using ABO in bleeding patients and lessons learned over the last 20 years from the endovascular treatment of ruptured abdominal aortic aneurysms (rAAA). We also briefly describe current knowledge of ABO usage in trauma.

A small series of educational cases in our hospital is described, where endovascular techniques were used to gain temporary hemorrhage control. The methods used for rAAA and their applicability to EVTM with a multidisciplinary approach are presented.

Establishing femoral arterial access immediately on arrival at the emergency room and use of an angiography table in the surgical suite may facilitate EVTM at an early stage. ABO may be an effective method for the temporary stabilization of severely hemodynamically unstable patients with hemorrhagic shock, and may be useful as a bridge to definitive treatment of the bleeding patients.

EVTM, including the usage of ABO, can be initiated on patient arrival and is feasible. Further data need to be collected to investigate proper indications for ABO, best clinical usage, results and potential complications. Accordingly, the ABOTrauma Registry has recently been set up. Existing experiences of EVTM and lessons from the endovascular treatment of rAAA may be useful in trauma management.

Place, publisher, year, edition, pages
Springer, 2016. Vol. 42, no 5, 585-592 p.
Keyword [en]
Hemorrhagic shock, Trauma, Intra-aortic balloon occlusion, Angiography, Access, Endovascular treatment
National Category
Cardiac and Cardiovascular Systems
Research subject
Cardiology
Identifiers
URN: urn:nbn:se:oru:diva-53378DOI: 10.1007/s00068-015-0574-0ISI: 000385176400008PubMedID: 26416402Scopus ID: 2-s2.0-84944620095OAI: oai:DiVA.org:oru-53378DiVA: diva2:1044416
Available from: 2016-11-03 Created: 2016-11-03 Last updated: 2017-03-27Bibliographically approved

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Hörer, Tal M.Skoog, PerPirouzram, ArtaiNilsson, Kristofer F.Larzon, Thomas
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