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Updated: Jun 30, 2026
Complete and Partial Aortic Occlusion for the Treatment of Hemorrhagic Shock in Swine
Published on: August 24, 2018
Impact of Resuscitative Endovascular Balloon Occlusion of the Aorta on In-Hospital and Short-Term Mortality: A
Hiroyuki Kamide1, Shingo Kato2, Naofumi Yasuda2
1Department of Diagnostic Radiology, Yokohama City University Medical Center, Yokohama 232-0024, Japan.
Background:
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is increasingly employed in patients with hemorrhagic shock and cardiovascular collapse; however, its impact on mortality remains controversial. Differences in geographic regions and patient populations may influence clinical outcomes.
Methods:
We conducted a systematic review and meta-analysis of observational studies comparing mortality between patients receiving REBOA and those managed without REBOA. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup analyses were performed according to propensity score (PS) matching, trauma versus non-trauma populations, and geographic regions.
Results:
A total of 10 studies involving 18,611 patients were included. Overall, REBOA was not associated with a significant reduction in mortality compared with non-REBOA (pooled OR = 0.52, 95% CI: 0.19-1.39, p = 0.19). In PS-matched studies, the pooled OR was 0.82 (95% CI: 0.34-1.98, p = 0.66), whereas in non-PS-matched studies it was 0.40 (95% CI: 0.12-1.26, p = 0.12). Geographic analyses revealed no significant mortality benefit in either Western studies (OR = 0.47, 95% CI: 0.12-1.89; p = 0.29) or non-Western studies (OR = 0.60, 95% CI: 0.11-3.38; p = 0.56). No survival benefit was observed among trauma patients (OR = 0.57, 95% CI: 0.20-1.61; p = 0.29), whereas a significant reduction in mortality was observed in non-trauma patients (OR = 0.21, 95% CI: 0.05-0.88; p = 0.03).
Conclusions:
In this systematic review and meta-analysis, REBOA was not associated with a significant reduction in mortality in the overall population or in trauma patients. However, in a single small non-trauma study (n = 53), REBOA was associated with significantly reduced mortality; this finding is exploratory and requires confirmation in larger prospective studies. These findings suggest that the clinical benefit of REBOA may depend on patient population and underlying etiology of hemorrhage.
