Resuscitative Endovascular Balloon Occlusion of the Aorta: A New Weapon to Combat Exsanguinating Hemorrhage
Hemorrhage is a leading cause of death from trauma, as well as from obstetrical emergencies and misadventures in elective surgery. While visible bleeding is easily managed by compression and vessel ligation even under battlefield conditions, noncompressible torso hemorrhage remains a lethal problem. Noncompressible torso hemorrhage can result from pelvic or retroperitoneal trauma, uterine disease or injury, or misplaced hardware in orthopedic procedures. Surgical visualization of injuries in the deep pelvis is difficult, and profuse bleeding can occur from a network of veins that offers no easy site for vascular control. Angiographic embolization is possible in modern facilities, but even in the best-equipped centers it can take time to mobilize the necessary resources. Too often the patient bleeds to death or sustains a lethal dose of shock before hemorrhage can be controlled.