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Complete and Partial Aortic Occlusion for the Treatment of Hemorrhagic Shock in Swine
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PARTIAL OCCLUSION, LESS AKI: AN AORTA REGISTRY ANALYSIS OF PREBOA-PRO
William Matthew Vassy1, Andrew Beckett2, Bradley Dennis3
1Northeast Georgia Medical Center, Gainesville, Georgia.
Shock (Augusta, Ga.)
|December 13, 2024
Summary
The pREBOA-PRO catheter, enabling longer partial aortic occlusion, resulted in less acute kidney injury compared to complete occlusion with the ER-REBOA catheter. This suggests pREBOA-PRO is a safer option for extended hemorrhage control.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Critical Care Medicine
Background:
- Noncompressible torso hemorrhage is a leading cause of preventable death.
- Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is used for hemorrhage control.
- Complete occlusion with ER-REBOA may cause distal ischemia beyond 30 minutes.
Purpose of the Study:
- To evaluate the impact of the pREBOA-PRO catheter on acute kidney injury (AKI) and mortality.
- To compare longer, partial occlusion times with pREBOA-PRO against complete occlusion with ER-REBOA.
- To assess the safety and efficacy of pREBOA-PRO for extended aortic occlusion.
Main Methods:
- Retrospective analysis of the Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery registry.
- Comparison of patients receiving partial occlusion with pREBOA-PRO (n=110) versus complete occlusion with ER-REBOA (n=752) in Zone 1.
- Analysis of demographics, clinical presentation, occlusion strategy, complications, and mortality.
Main Results:
- Partial aortic occlusion was used more frequently and for longer durations with pREBOA-PRO (87%, 59 min) versus ER-REBOA (33%, 50 min).
- Acute kidney injury occurred less frequently in the pREBOA-PRO group (19%) compared to the ER-REBOA group (33%).
- Demographics, clinical presentation, and mortality were similar between groups, with higher age in the ER-REBOA group.
Conclusions:
- The pREBOA-PRO catheter facilitates more frequent and longer partial aortic occlusion in Zone 1.
- This strategy is associated with a lower incidence of acute kidney injury.
- pREBOA-PRO represents a potentially safer extended bridge to definitive hemorrhage control.
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