Smaller introducer sheaths for REBOA may be associated with fewer complications.

Introduction: Large arterial sheaths currently used for Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) may be associated with severe complications. Smaller diameter catheters compatible with 7Fr sheaths may improve the safety profile. Methods: A retrospective review of patients receiving REBOA through a 7Fr sheath for refractory traumatic hemorrhagic shock was performed from January 2014 to June 2015 at 5 tertiary care hospitals in Japan. Demographics were collected including method of arterial access; outcomes included mortality and REBOA-related access complications. Results: 33 patients underwent REBOA at Zone 1 (level of the diaphragm). Most patients were male (70%), with a mean age (+SD) 50+/-18 years, mean BMI 23+/-4 and a median [IQR] ISS of 38 [34, 52]. 94% of patients presented after sustaining injuries from blunt mechanisms. 24% underwent CPR before arrival, and an additional 15% received CPR after admission. Percutaneous arterial access without ultrasound or fluoroscopy was achieved in all patients. Systolic blood pressure (SBP) increased significantly following balloon occlusion (mean 62 +/- 36 to 106 +/- 40 mmHg, p

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