How I do it: Partial resuscitative endovascular balloon occlusion of the aorta (P-REBOA)

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Resuscitative endovascular balloon occlusion of the aorta (REBOA) continues to evolve as a potentially viable tool of modern trauma resuscitation.1–5 Although optimal patient selection and techniques continue to be refined, REBOA has emerged as a practical tool that can be used in the care of patients with noncompressible truncal hemorrhage (NCTH) who fail to respond adequately to other resuscitative interventions.
While the basic rationale for REBOA have not changed dramatically in the last 2 years, advances in techniques and the development of trauma-specific devices have simplified the conduct of this procedure and may serve to mitigate some of the inherent risks and access site complications associated with aortic occlusion. Specifically, the recent Food and Drug Administration's approval of the Prytime ER-REBOA catheter (Boerne, TX, USA) and the introduction of partial-REBOA (P-REBOA) approaches6 have likely improved the efficacy with which REBOA can be used to potentially salvage patients in extremis due to NCTH.
This video supplement will outline the approach used by the author to use REBOA in the clinical setting. All video elements outlining the steps used were obtained in either a cadaver or animal laboratory setting.
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