Resuscitative Endovascular Balloon Occlusion of the Aorta

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive procedure performed during resuscitation of critically injured trauma patients, developed as a less invasive alternative to emergency thoracotomy with aortic cross clamping, to gain rapid control of non-compressible truncal or junctional hemorrhage. It is performed by achieving access to the common femoral artery and advancing a catheter within the aorta, then inflating an occluding balloon within the descending thoracic aorta or infrarenal abdominal aorta, which stanches downstream hemorrhage and improves cardiac index, cerebral perfusion and coronary perfusion. REBOA does not eliminate the need for definitive hemorrhage control and carries significant local and systemic ischemic risks, and while it has been successfully used in adult patients it has not yet been studied in children.