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REBOA: The Dark Side
COL Matthew J. Martin, MD Madigan Army Medical Center Taking the Winning Position
2016 Austin Trauma Critical Care Conference
R E B O A
esuscitative ndovascular alloon
- rta
REBOA: The Dark Side COL Matthew J. Martin, MD Madigan Army Medical - - PowerPoint PPT Presentation
REBOA: The Dark Side COL Matthew J. Martin, MD Madigan Army Medical - - PowerPoint PPT Presentation
2016 Austin Trauma Critical Care Conference REBOA: The Dark Side COL Matthew J. Martin, MD Madigan Army Medical Center Taking the Winning Position R esuscitative E ndovascular B alloon O cclusion of the A orta REBOA is a GREAT idea
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REBOA is a GREAT idea
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REBOA is a GREAT idea
Known pathology No OTHER problems Have some time Vascular surgeon Controlled access
and placement
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The “Unstable” Trauma Patient
Chaotic Unclear extent of injuries Unclear location of injuries
could be harmful w REBOA
Trauma/EM doc with less experience Access much more difficult Scoop and RUN! May have only one shot
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Early Complications
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More Vascular Complications?
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Animal Studies
Anesthetized healthy animal Controlled OR environment Single injury – usually vascular Direct vascular access Perfect placement NON survival
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Norii T, et al. J Trauma and Acute Care Surg, 2015
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41 Studies "Evidence base is weak" "NO clear reduction in mortality" Significant device-related morbidity
reported
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“REBOA would appear to be well suited to the geography of Scotland, which includes a spectrum of topography ranging from major urban lowland regions to rural Northern and island territories. Morrison JJ. The Surgeon. 2014
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Direct to OR
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Massive Ischemia-Reperfusion Injury
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Massive Ischemia-Reperfusion Injury
30 minutes 30 minutes 60 minutes 60 minutes
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The Clock is Ticking!
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Adjunct for Nonoperative Management?
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