Feasibility of computer-aided aortic occlusion catheter in non-traumatic cardiac arrest

The persistently high mortality rate following cardiac arrest over the past decades underscores the urgent need for advancements in resuscitation strategies. Animal studies have shown increased coronary and cerebral perfusion during cardiopulmonary resuscitation following endovascular balloon occlusion of the aorta.

This single-arm study investigated the feasibility and safety of a novel computer-aided automated aortic occlusion catheter (NEURESCUE® Catheter & NEURESCUE® Assistant) as an adjunct to advanced cardiac life support in patients with non-traumatic cardiac arrest. Both in-hospital and out-of-hospital cardiac arrest cases were included in two German tertiary care hospitals (University Hospital of Heidelberg and Deutsches Herzzentrum der Charité (DHZC) Berlin). The primary endpoint was defined as successful balloon inflation within 10 min from the first vessel puncture. The primary safety endpoint was a composite of adverse outcomes, including blood vessel damage resulting from the device requiring surgical or endovascular intervention, arterial thromboembolism necessitating surgical or endovascular intervention, lower extremity amputation, renal failure requiring non-temporary renal replacement therapy, and lower extremity paralysis.

In total, ten subjects were enrolled in the trial. The balloon was successfully implanted in ten out of ten (100 %) subjects. The primary endpoint was achieved in eight out of nine with a mean time of 5.4 min (±2.5 min) from first vessel puncture to total aortic balloon occlusion. Systolic, diastolic, and mean arterial blood pressure during resuscitation were increased in 80 % of the patients after two minutes of aortic occlusion by 24.6 mmHg (baseline mean: 44.1 mmHg), 7.3 mmHg (baseline mean: 23.4 mmHg) and 13.0 mmHg (baseline mean: 30.3 mmHg), respectively. The primary composite safety endpoint was evident in one patient, who experienced renal failure requiring renal replacement therapy.

A computer-aided automated aortic occlusion catheter can be safely implanted with a high success rate with regards to procedure time during ongoing cardiopulmonary resuscitation in patients suffering from cardiac arrest of non-traumatic origin.