Advertisement

Endovascular Techniques in Hemorrhage Control and Resuscitation

  • Joe DuBose
  • Todd E. Rasmussen
Chapter

Abstract

Advances in endovascular technologies have demonstrated their promise as potential damage control adjuncts. Resuscitative endovascular balloon occlusion of the aorta (REBOA) and other novel devices may provide solutions to some of the significant challenges of hemorrhage from non-compressible sites. This chapter outlines available endovascular tools for utilization and discusses their potential and present limitations.

References

  1. 1.
    Reuben BC, Whitten MG, Sarfati M, Kraiss LW. Increasing use of endovascular therapy in acute arterial injuries: analysis of the National Trauma Data Bank. J Vasc Surg. 2007;46(6):1222.CrossRefPubMedGoogle Scholar
  2. 2.
    Avery LE, Stahfield KR, Corcos AC, Scifres AM, Ziembicki JA, Varcelotti J, Peitzman AB, Billiar TR, Sperry JL. Evolving role of endovascular techniques for traumatic vascular injury: a changing landscape. J Trauma Acute Care Surg. 2012;72(1):41–6.CrossRefPubMedGoogle Scholar
  3. 3.
    Gerlock AJ. Hemorrhage following pelvic fracture controlled by embolization: case report. J Trauma. 1975;15(8):740–2.CrossRefPubMedGoogle Scholar
  4. 4.
    Chuang VP, Reuter SR, Walter J, Foley WD, Bookstein JJ. Control of renal hemorrhage by selective arterial embolization. Am J Roentgenol Radium Therapy, Nucl Med. 1975;125(2):300–6.CrossRefGoogle Scholar
  5. 5.
    Barbaric ZL, Luka NL. Angiographic demonstration and transcatheter embolic control of post-traumatic intercostal arterial hemorrhage. Surgery. 1977;81(4):409–12.PubMedGoogle Scholar
  6. 6.
    Ayella RJ, DuPriest RW Jr, Khaneja SC, Maekawa K, Soderstrom CA, Rodriguez A, Cowley RA. Transcatheter embolization of autologous clot in the management of bleeding associated with fractures of the pelvis. Surg Gynecol Obstet. 1978;147(6):849–52.PubMedGoogle Scholar
  7. 7.
    Maull KI, Sachatello CR. Current management of pelvic fractures: a combined surgical-angiographic approach to hemorrhage. South Med J. 1976;69(10):1285–9.CrossRefPubMedGoogle Scholar
  8. 8.
    van Urk H, Perlberger RR, Muller H. Selective arterial embolization for control of traumatic pelvic hemorrhage. Surgery. 1978;83(2):133–7.PubMedGoogle Scholar
  9. 9.
    Panetta T, Sclafani SJ, Goldstein AS, Phillips TF, Shaftan GW. Percutaneous transcatheter embolization for massive bleeding from pelvic fractures. J Trauma. 1985;25(11):1021–9.PubMedGoogle Scholar
  10. 10.
    Sclafani SJ, Weisberg A, Scalea TM, Phillips TF, Duncan AO. Blunt splenic injuries: nonsurgical treatment with CT, arteriography, and transcatheter arterial embolization of the splenic artery. Radiology. 1991;181(1):189–96.CrossRefPubMedGoogle Scholar
  11. 11.
    Sclafani SJ, Shaftan GW, Scalea TM, Patterson LA, Kohl L, Kantor A, Herskowitz MM, Hoffer EK, Henry S, Dresner LS, et al. Nonoperative salvage of computed tomography-diagnosed splenic injuries: utilization of angiography for triage and embolization for hemostasis. J Trauma. 1995;39(5):818–25; discussion 826–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Roudsari BS, Psoter K, Padia SA, Kogut MJ, Kwan SW. Utilization of angiography and embolization for abdominopelvic trauma: 14 years’ experience at level 1 trauma center. AJR. 2014;202:W580–5.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Ierardi AM, Piacentino F, Fontana F, Petrillo M, Floridi C, Bacuzzi A, Cuffari S, Elabbassi W, Novario R, Carrafiello G. The role of endovascular treatment of pelvic bleeding in emergency settings. Eur Radiol. 2015;25(7):1854–64.CrossRefPubMedGoogle Scholar
  14. 14.
    Niola R, Pinto A, Sparano A, Ignarra R, Romano L, Maglione F. Arterial bleeding in pelvic trauma: priorities in angiographic embolization. Curr Probl Diagn Radiol. 2012;41(3):93–101.CrossRefPubMedGoogle Scholar
  15. 15.
    Velmahos GC, Toutouzas KG, Vassiliu P, Sarkisvan G, Chan LS, Hanks SH, Berne TV, Demetriades D. A prospective study on the safety and efficacy of angiographic embolization for pelvic and visceral injuries. J Trauma. 2002;53(2):303–8;discussion 308.CrossRefPubMedGoogle Scholar
  16. 16.
    Misselbeck TS, Teicher EJ, Cippolle MD, Pasquale MD, Shah KT, Dangleben DA, Badelling MM. Hepatic angioembolization in trauma patients: indications and complications. J Trauma. 2009;67(4):769–73.CrossRefPubMedGoogle Scholar
  17. 17.
    Ierardi AM, Duka E, Lucchina N, Floridi C, De Martino A, Donat D, Fontana F, Carrafiello G. The role of interventional radiology in abdominopelvic trauma. Br J Radiol. 2016;5:20150866. [Epub ahead of print].CrossRefGoogle Scholar
  18. 18.
    Zarzaur BL, Kozar R, Myers JG, Claridge JA, Scalea TM, Neideen TA, Maung AA, Alarcon L, Corcos A, Kerwin A, Coimbra R. The splenic injury outcomes trial: an American Association for the Surgery of Trauma multi-institutional study. J Trauma Acute Care Surg. 2015;79(3):335–42. Ogura T1, Lefor AT, Nakano M, Izawa Y, Morita H. Nonoperative management of hemodynamically unstable abdominal trauma patients with angioembolization and resuscitative endovascular balloon occlusion of the aorta. J Trauma Acute Care Surg. 2015 Jan;78(1):132-5.CrossRefPubMedGoogle Scholar
  19. 19.
    Schwartz DA, Medina M, Cotton BA, Rahbar E, Wade CE, Cohen AM, Beeler AM, Burgess AR, Holcomb JB. Are we delivering two standards of care for pelvic trauma? Availability of angioembolization after hours and on weekends increases time to therapeutic intervention. J Trauma Acute Care Surg. 2014;76(1):134–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Brenner M, Hoehn M, Teeter W, Stein D, Scalea T. Trading scalpels for sheaths: catheter-based treatment of vascular injury can be effectively performed by acute care surgeons trained in endovascular techniques. J Trauma Acute Care Surg. 2016;80(5):783–6.CrossRefPubMedGoogle Scholar
  21. 21.
    Holcomb JB, Fox EE, Scalea TM, Napolitano LM, Albarado R, Gill B, Dunkin BJ, Kirkpatrick AW, Cotton BA, Inaba K, DuBose JJ, Cohen AA, Azizzadeh A, Brenner M, Cohen MJ, Wade CE, Lumsden AB, Andrassy R, Rhee PM, Bass BL, Mattox KL, Britt LD, Eastman AB, Hoyt DB, Rasmussen TE. Current opinion on catheter-based hemorrhage control in trauma patients. J Trauma Acute Care Surg. 2014;76:888–93.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Demetriades D, Velmahos G, Scalea T, et al. Operative repair or endovascular stent/graft in blunt traumatic thoracic aortic injuries: results of an AAST multicenter study. J Trauma. 2008;64:561–70.CrossRefPubMedGoogle Scholar
  23. 23.
    DuBose JJ, Leake SS, Brenner M, Pasley J, O’Callaghan T, Luo-Owen X, Trust MD, Mooney J, Zhao FZ, Azizzadeh A, Aortic Trauma Foundation. Contemporary management and outcomes of blunt thoracic aortic injury: a multicenter retrospective study. J Trauma Acute Care Surg. 2015;78(2):360–9.CrossRefPubMedGoogle Scholar
  24. 24.
    Mattox KL, Wall MJ. Historical review of blunt injury to the thoracic aorta. Chest Surg Clin N Am. 2000;10:167–82.PubMedGoogle Scholar
  25. 25.
    Fabian TC, Richardson JD, Groce MA, et al. Prospective study of blunt aortic injury: multicenter trial of the American Association for the Surgery of Trauma. J Trauma. 1997;42:374–80.CrossRefPubMedGoogle Scholar
  26. 26.
    Demetriades D, Velmahos GC, Scalea TM, et al. Diagnosis and treatment of blunt thoracic aortic injuries: changing perspectives. J Trauma. 2008;64:1415–9.CrossRefPubMedGoogle Scholar
  27. 27.
    Arthurs ZM, Starnes BW, Sohn VY, Singh N, Martin MJ, Andersen CA. Functional and survival outcomes in traumatic blunt thoracic aortic injuries: an analysis of the National Trauma Databank. J Vasc Surg. 2009;49:988–94.CrossRefPubMedGoogle Scholar
  28. 28.
    Lee WA, Matsumura J, Mitchell RS, et al. Endovascular repair of traumatic thoracic aortic injury: clinical practice guidelines of the Society for Vascular Surgery. J Vasc Surg. 2011;53:187–92.CrossRefPubMedGoogle Scholar
  29. 29.
    Piffaretti G, Benedetto F, Menegolo M, et al. Outcomes of endovascular repair for blunt thoracic aortic injury. J Vasc Surg. 2013;58:1483–9.CrossRefPubMedGoogle Scholar
  30. 30.
    Khoynezhad A, Azizzadeh A, Donayre CE, Matsumoto A, Velazquez O, White R. RESCUE investigators. Results of a multicenter, prospective trial of thoracic endovascular aortic repair for blunt thoracic aortic injury (RESCUE trial). J Vasc Surg. 2013;57(4):899–905.CrossRefPubMedGoogle Scholar
  31. 31.
    Azizzadeh A, Ray HM, Dubose JJ, Charlton-Ouw KM, Miller CC, Coogan SM, Safi HJ, Estrera AL. Outcomes of endovascular repair for patients with blunt traumatic aortic injury. J Trauma Acute Care Surg. 2014;76(2):510–6.3.CrossRefPubMedGoogle Scholar
  32. 32.
    Lamarche Y, Berger FH, Nicolaou S, Bilawich AM, Louis L, Inacio JR, Janusz MT, Evans D. Vancouver simplified grading system with computed tomographic angiography for blunt aortic injury. J Thorac Cardiovasc Surg. 2012;144(2):347–54, 354.e1.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Starnes BW, Lundgren RS, Gunn M, Quade S, Hatsukami TS, Tran NT, Mokadam N, Aldea G. A new classification scheme for treating blunt aortic injury. J Vasc Surg. 2012;55(1):47–54.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Rabin J, DuBose J, Sliker CW, O'Connor JV, Scalea TM, Griffith BP. Parameters for successful non operative management of traumatic aortic injury. J Thorac Cardiovasc Surg. 2014;147(1):143–9.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Branco BC, DuBose JJ, Zhan LX, Hughes JD, Goshima KR, Rhee P, Mills JL Sr. Trends and outcomes of endovascular therapy in the management of civilian vascular injuries. J Vasc Surg. 2014;60(5):1297–307.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Branco BC, Boutrous ML, DuBose JJ, Leake SS, Charlton-Ouw K, Rhee P, Mills JL, Azizzadeh A. Outcome comparison between open and endovascular management of axillosubclavian arterial injuries. J Vasc Surg. 2016;63(3):702–9.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Shalhub S, Starnes BW, Tran NT, Hatsukami TS, Lundgren RS, Davis CW, Quade S, Gunn M. Blunt abdominal aortic injury. J Vasc Surg. 2012;55(5):1277–85.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Willis M, Neschis D, Menaker J, Lilly M, Scalea T. Stent grafting for a distal thoracic aortic injury. Vasc Endovasc Surg. 2011;45(2):187–90.CrossRefGoogle Scholar
  39. 39.
    Hughes C. Use of intra-aortic balloon catheter tamponade for controlling intra-abdominal hemorrhage in man. Surgery. 1954;36(1):65–8.PubMedGoogle Scholar
  40. 40.
    White JM, Cannon JW, Stannard A, Markov NP, Spencer JR, Rasmussen TE. Endovascular balloon occlusion of the aorta is superior to resuscitative thoracotomy with aortic clamping in a porcine model of hemorrhagic shock. Surgery. Mosby, Inc. 2011;150(3):400–9.CrossRefPubMedGoogle Scholar
  41. 41.
    Ho rer TM, Cajander P, Jans A, Nilsson KF. A case of partial aortic balloon occlusion in an unstable multi-trauma patient. Trauma. 2016;18(2):150–4.CrossRefGoogle Scholar
  42. 42.
    Ogura T, Lefor A, Nakano M, Izawa Y, Morita H. Nonoperative management of hemodynamically unstable abdominal trauma patients with angioembolization and resuscitative endovascular occlusion of the aorta. J Trauma Acute Care Surg. 2015;78(1):132–5.CrossRefPubMedGoogle Scholar
  43. 43.
    Morrison JJ, Ross JD, Rt H, Watson JD, Sokol KK, Rasmussen TE. Use of resuscitative endovascular balloon occlusion of the aorta in a highly lethal model of noncompressible torso hemorrhage. Shock. 2014;41(2):130–7.CrossRefPubMedGoogle Scholar
  44. 44.
    Davidson AJ, Russo RM, DuBose JJ, Roberts J, Jurkovich GJ, Galante JM. Potential benefit of early operative utilization of low profile, partial resuscitative endovascular balloon occlusion of the aorta (P-REBOA) in major traumatic hemorrhage. Trauma Surgery & Acute Care Open. 2016;1(1):1–3.CrossRefGoogle Scholar
  45. 45.
    Okumura E, Tsurukiri J, Oomura T, Tanaka Y, Oomura R. Partial resuscitative endovascular balloon occlusion of the aorta as a hemorrhagic shock adjunct for ectopic pregnancy. Am J Emerg Med. 2016;34(9):1917.e1–2.CrossRefGoogle Scholar
  46. 46.
    Russo RM, Neff LP, Lamb CM, Cannon JW, Galante JM, Clement NF, et al. Partial resuscitative endovascular balloon occlusion of the aorta in swine model of hemorrhagic shock. J Am Coll Surg. 2016;223(2):359–68.CrossRefPubMedGoogle Scholar
  47. 47.
    Johnson MA, Neff LP, Williams TK, DuBose JJ, Group ES. Partial resuscitative balloon occlusion of the AORTA (P-REBOA): clinical technique and rationale. J Trauma Acute Care Surg. 2016;81(5 Suppl 2):S133–7.CrossRefPubMedGoogle Scholar
  48. 48.
    Russo RM, Williams TK, Grayson JK, Lamb CM, Cannon JW, Clement NF, et al. Extending the golden hour: partial resuscitative endovascular balloon occlusion of the aorta in a highly lethal swine liver injury model. J Trauma Acute Care Surg. 2016;80(3):372–80.CrossRefPubMedGoogle Scholar
  49. 49.
    Saito N, Matsumoto H, Yagi T, Hara Y, Hayashida K, Motomura T, Mashiko K, Iida H, Yokota H, Wagatsuma Y. Evaluation of the safety and feasibility of resuscitative endovascular balloon occlusion of the aorta. J Trauma Acute Care Surg. 2015;78(5):897–903; discussion 904.CrossRefPubMedGoogle Scholar
  50. 50.
    Du Bose JJ, Scalea T, Brenner M, Skiada D, Inaba K, Cannon J, Moore L, Holcomb J, Turay D, Luo-Owen X, Kirkpatrick A, Xiao J, Skarupa D, Poulin N, AAST AORTA Study Group. The AAST prospective aortic occlusion for resuscitation in trauma and acute Care Surgery (AORTA) registry: contemporary utilization and outcomes of aortic occlusion and REBOA. J Trauma Acute Care Surg. 2016;81(3):409–19.CrossRefGoogle Scholar
  51. 51.
    Brenner ML, Moore LJ, DuBose JJ, Tyson GH, McNutt MK, Albarado RP, Holcomb JB, Scalea TM, Rasmussen TE. A clinical series of resuscitative endovascular balloon occlusion of the aorta for hemorrhage control and resuscitation. J Trauma Acute Care Surg. 2013;75(3):506–11.CrossRefPubMedGoogle Scholar
  52. 52.
    Moore LJ, Brenner M, Kozar RA, Pasley J, Wade CE, Baraniuk MS, Scalea T, Holcomb JB. Implementation of resuscitative endovascular balloon occlusion of the aorta as an alternative to resuscitative thoracotomy for noncompressible truncal hemorrhage. J Trauma Acute Care Surg. 2015;79(4):523–30; discussion 530–2.CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Brenner M, Hoehn M, Pasley J, Dubose J, Stein D, Scalea T. Basic endovascular skills for trauma course: bridging the gap between endovascular techniques and the acute care surgeon. J Trauma Acute Care Surg. 2014;77(2):286–91.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Joe DuBose
    • 1
    • 2
  • Todd E. Rasmussen
    • 3
    • 4
  1. 1.R Adams Cowley Shock Trauma CenterUniversity of MarylandBaltimoreUSA
  2. 2.Uniformed Services University of the Health SciencesBethesdaUSA
  3. 3.F. Edward Hebert School of Medicine—“America’s Medical School”Uniformed Services University of the Health SciencesBethesdaUSA
  4. 4.Walter Reed National Military Medical CenterBethesdaUSA

Personalised recommendations