Open AccessResuscitative endovascular balloon occlusion of the aorta in combat casualties: The past, present, and future
Author(s) -
Sarah C. Stokes,
Christina M. Theodorou,
Scott Zakaluzny,
Joseph J. DuBose,
Rachel M. Russo
Publication year - 2021
Publication title -
the journal of trauma and acute care surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.25
H-Index - 187
eISSN - 2163-0763
pISSN - 2163-0755
DOI - 10.1097/ta.0000000000003166
Subject(s) - medicine , battlefield , aorta , balloon , surgery , history , ancient history
Noncompressible torso hemorrhage is a leading cause of preventable death on the battlefield. Intra-aortic balloon occlusion was first used in combat in the 1950s, but military use was rare before Operation Iraqi Freedom and Operation Enduring Freedom. During these wars, the combination of an increasing number of deployed vascular surgeons and a significant rise in deaths from hemorrhage resulted in novel adaptations of resuscitative endovascular balloon occlusion of the aorta (REBOA) technology, increasing its potential application in combat. We describe the background of REBOA development in response to a need for minimally invasive intervention for hemorrhage control and provide a detailed review of all published cases (n = 47) of REBOA use for combat casualties. The current limitations of REBOA are described, including distal ischemia and reperfusion injury, as well as ongoing research efforts to adapt REBOA for prolonged use in the austere setting.