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Updated: Sep 20, 2026
Complete and Partial Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock
Published on: May 19, 2022
[CT-guided aortic balloon occlusion in traumatic abdominal and pelvic bleeding]
U Linsenmaier1, K-G Kanz, J Rieger
1Institut für Klinische Radiologie, Klinikum der Universität München, Innenstadt, Ludwig-Maximilians-Universität München. lin@ch-i.med.uni-muenchen.de
Insights
This study introduces CT-guided aortic balloon occlusion for severe bleeding. The minimally invasive technique offers rapid hemorrhage control in trauma patients, improving hemodynamic stability.
Area of Science:
- Interventional Radiology
- Trauma Surgery
- Emergency Medicine
Background:
- Life-threatening abdominal and pelvic bleeding in trauma patients requires rapid hemorrhage control.
- Conventional resuscitation may be insufficient in cases of severe, ongoing bleeding.
Purpose of the Study:
- To present a novel interventional radiology technique: CT-guided aortic balloon occlusion.
- To evaluate its efficacy in achieving immediate bleeding control in unstable trauma patients.
Main Methods:
- Three male patients with multiple trauma and active bleeding underwent CT-guided aortic balloon occlusion via a femoral approach.
- Guidewire and balloon catheter positioning were confirmed with CT scans and fluoroscopy.
- One patient also received CT-guided pelvic C-clamp application for fracture stabilization.
Main Results:
- CT-guided aortic balloon occlusion was technically successful with an intervention time of 4-6 minutes.
- All patients achieved temporary hemodynamic stabilization, with systolic blood pressure rising above 100 mmHg.
- Two patients expired due to severe injuries (ISS 50-64), despite initial stabilization.
Conclusions:
- CT-guided aortic occlusion is a fast and effective method for controlling hemorrhage in trauma patients.
- The procedure can be integrated with other emergency interventions.
- Further studies with larger patient cohorts are needed to fully assess this technique.
Purpose:
To introduce a new interventional method for CT-guided aortic balloon occlusion in patients with life-threatening abdominal or pelvic bleeding.
Materials And Methods:
Three male patients (age 18, 30, and 45 years) with multiple trauma underwent CT-guided balloon occlusion of the aorta after CT identified an active abdominal or pelvic bleeding site and the patients became unstable (systolic blood pressure, BP < 80 mm Hg) despite resuscitation continuous volume. Using a right femoral approach, a 9F sheath was immediately introduced and the positions of the guide wire and balloon catheter (20 x 40 mm) were intermittently checked with CT scans and CT fluoroscopy. In one case, a C-clamp was applied to the pelvic ring under CT guidance for emergency stabilization of an unstable pelvic fracture.
Results:
CT-guided aortic balloon occlusion and the mounting of the pelvic C-clamp were technically successful. Intervention time was 4 to 6 minutes for aortic balloon occlusion. All patients became at least temporarily stable hemodynamically with the blood pressure rising above 100 mmHg. The infrarenal occlusion catheters were left in place up to 60 minutes. Suprarenal occlusion was not performed. Two patients died due to protracted shock and complex injuries (injury severity score (ISS: 50 - 64).
Conclusion:
CT-guided aortic occlusion provides fast and effective bleeding control immediately after completion of the diagnostic CT. The procedure can be combined with other specific emergency surgical or interventional procedures. Experience with more patients is necessary for further evaluation of this new technique.
