Successful management for a ruptured abdominal aortic aneurysm using resuscitative endovascular balloon occlusion of the aorta via the brachial artery route—a case report
1Department of Anesthesiology and Pain Medicine, Dankook University College of Medicine, 31144 Cheonan, Republic of Korea
2Department of Anesthesiology and Pain Medicine, Dankook University Hospital, 31144 Cheonan, Republic of Korea
Submitted: 25 August 2021 Accepted: 14 October 2021
Online publish date: 16 November 2021
Ruptured abdominal aortic aneurysms pose a challenge to anesthesiologists. Resus-citative thoracotomy and aorta-cross clamping are used to prevent cardiopulmonary collapse during ruptured abdominal aortic aneurysm repair. Recently, resuscitative endovascular balloon obstruction of the aorta has been introduced as an alternative to resuscitative thoracotomy and aorta-cross clamping. Resuscitative endovascular balloon obstruction of the aorta is a minimally invasive and low risk procedure compared to resuscitative thoracotomy and aorta-cross clamping, with minimal blood-borne pathogen exposure to healthcare workers. A 63-year-old man was scheduled for emergency repair of a ruptured abdominal aortic aneurysms. The patient’s vital signs were unstable, and aggressive treatment with transfusion and vasopressor infusion was not effective. Resuscitative endovascular balloon obstruction of the aorta was performed using the brachial artery. After initiation of resuscitative endovascular balloon obstruction of the aorta, the patient’s vital signs immediately stabilized, and hematoma evacuation and aorta reconstruction were completed successfully. The total balloon inflation time during resuscitative endovascular balloon obstruction of the aorta was approximately 45 min. The patient was discharged on the 62nd postoperative day. Resuscitative endovascular balloon obstruction of the aorta is a promising minimally invasive alternative to resuscitative thoracotomy and aorta-cross clamping in patients with ruptured abdominal aortic aneurysms. Resuscitative endovascular balloon obstruction of the aorta may also be a good treatment option for patients with non-compressible torso bleeding under the diaphragm.
Aortic aneurysm; Aortic rupture; Balloon occlusion; Endovascular procedures
Seokkon Kim,Jaegyok Song,Nayoung Choi. Successful management for a ruptured abdominal aortic aneurysm using resuscitative endovascular balloon occlusion of the aorta via the brachial artery route—a case report. Signa Vitae. 2021.doi:10.22514/sv.2021.232.
 Sakalihasan N, Limet R, Defawe O. Abdominal aortic aneurysm. The Lancet. 2005; 365: 1577–1589.
 Manzano Nunez R, Naranjo MP, Foianini E, Ferrada P, Rincon E, García-Perdomo HA, et al. A meta-analysis of resuscitative endovascular balloon occlusion of the aorta (REBOA) or open aortic cross-clamping by resuscitative thoracotomy in non-compressible torso hemorrhage patients. World Journal of Emergency Surgery. 2017; 12: 30.
 Brenner M, Teeter W, Hoehn M, Pasley J, Hu P, Yang S, et al. Use of Resuscitative Endovascular Balloon Occlusion of the Aorta for Proximal Aortic Control in Patients with Severe Hemorrhage and Arrest. JAMA Surgery. 2018; 153: 130–135.
 Ribeiro Junior MAF, Feng CYD, Nguyen ATM, Rodrigues VC, Bechara GEK, de-Moura RR, et al. The complications associated with Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA). World Journal of Emergency Surgery. 2018; 13: 20.
 Teeter WA, Bradley MJ, Romagnoli A, Hu P, Li Y, Stein DM, et al. Treatment Effect or Effective Treatment? Cardiac Compression Fraction and End-tidal Carbon Dioxide are Higher in Patients Resuscitative En-dovascular Balloon Occlusion of the Aorta Compared with Resuscitative Thoracotomy and Open-Chest Cardiac Massage. The American Surgeon. 2018; 84: 1691–1695.
 Biffl WL, Fox CJ, Moore EE. The role of REBOA in the control of exsanguinating torso hemorrhage. Yhe Journal of Trauma and Acute Care Surgery. 2015; 78: 1054–1058.
 Hilbert-Carius P, McGreevy D, Abu-Zidan FM, Hörer TM. Successfully REBOA performance: does medical specialty matter? International data from the ABOTrauma Registry. World Journal of Emergency Surgery. 2020; 15: 62.
 Stannard A, Eliason JL, Rasmussen TE. Resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct for hemorrhagic shock. The Journal of Trauma. 2012; 71: 1869–1872.
 Hoehn MR, Hansraj NZ, Pasley AM, Brenner M, Cox SR, Pasley JD, et al. Resuscitative endovascular balloon occlusion of the aorta for non-traumatic intra-abdominal hemorrhage. European Journal of Trauma and Emergency Surgery. 2019; 45: 713–718.
 Brenner M, Inaba K, Aiolfi A, DuBose J, Fabian T, Bee T, et al. Resuscitative Endovascular Balloon Occlusion of the Aorta and Resuscitative Thoracotomy in Select Patients with Hemorrhagic Shock: Early Results from the American Association for the Surgery of Trauma’s Aortic Occlusion in Resuscitation for Trauma and Acute Care Surgery Registry. Journal of the American College of Surgeons. 2018; 226: 730–740.
 Borger van der Burg BLS, van Dongen TTCF, Morrison JJ, Hedeman Joosten PPA, DuBose JJ, Hörer TM, et al. A systematic review and meta-analysis of the use of resuscitative endovascular balloon occlusion of the aorta in the management of major exsanguination. European Journal of Trauma and Emergency Surgery. 2018; 44: 535–550.
 Ellis DY. REBOA: where are we now? Emergency Medicine Australasia. 2020; 32: 4–6.
 Osborn LA, Brenner ML, Prater SJ, Moore LJ. Resuscitative endovas-cular balloon occlusion of the aorta: current evidence. Open Access Emergency Medicine. 2020; 11: 29–38.
 Wasicek PJ, Teeter WA, Brenner ML, Hoehn MR, Scalea TM, Morrison JJ. Resuscitative endovascular balloon occlusion of the aorta: rupture risk and implications for blind inflation. Trauma Surgery & Acute Care Open. 2018; 3: e000141.
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