In severe trauma there is a need to control massive hemorrhage. Deployment of REBOA (resuscitation endovascular balloon occlusion of the aorta) can control bleeding but must be placed carefully to achieve objectives and to avoid complications.
Complications that can occur with deployment of the endovascular balloon:
(1) ischemia of the lower extremities
(2) acute renal failure
(3) acute intestinal ischemia
The balloon may be placed in one of 3 anatomic zones of the aorta.
Zone
Description
Use
I
between left subclavian artery and celiac artery
massive intra-abdominal hemorrhage
II
between celiac artery and caudal renal artery
avoided due to risk of complications
III
from below the caudal renal artery and the aortic bifurcation
massive pelvic or lower limb hemorrhage
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