Vascular complications from resuscitative endovascular balloon occlusion of the aorta (REBOA): Life over limb?.

Background: Vascular complications from resuscitative endovascular balloon occlusion of the aorta (REBOA) have been reported as high as 13% with some patients requiring lower extremity amputation. We sought to review our institutions series of REBOA and assess our vascular complications. Methods: Retrospective review of all patients undergoing REBOA from October 2011 through July 2016. Data was gathered from the Memorial Hermann Trauma registry and the hospital electronic medical records. Operative details and vascular injuries from arterial access for REBOA insertion were recorded. Results: 48 patients underwent REBOA during our study period. 38 had the 14FR system placed and 10 had the 7FR system placed. Of the 24 surviving to removal of the 14FR sheath, 19 had primary repair of the arteriotomy without vascular complication. The other 5 required additional vascular procedures to repair arteriotomy with no lower extremity amputations. There were no vascular complications of sheath removal with the 7FR system, with no amputations. Conclusions: Implementation of REBOA can be done safely without increased risk of vascular access complications or limb loss. The 14FR system will more likely require further vascular procedures to address the access site, while the 7FR system will not. Level of Evidence: II Type of Study: Therapeutic/Care Management (C) 2017 Lippincott Williams & Wilkins, Inc.

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