Zhang Jackie, Watson J Devin, Drucker Charles, Kalsi Richa, Crawford Robert S, Toursavadkohi Shahab A, Flohr Tanya
Division of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD.
Division of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD.
Ann Vasc Surg. 2019 Apr;56:354.e5-354.e9. doi: 10.1016/j.avsg.2018.08.108. Epub 2018 Nov 27.
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is being considered for temporizing catastrophic hemorrhage before arriving at a specialty center for definitive surgical management.
We describe the clinical case of a 72-year-old male with a ruptured infrarenal aortic abdominal aneurysm initially stabilized with REBOA at an outside facility and transferred to our care. Transport time was >100 minutes. Despite successful surgical repair of the ruptured aneurysm, the patient expired from multiple-organ failure likely related to ischemia-reperfusion injuries from prolonged balloon occlusion of the aorta.
Ischemia-mitigating techniques and therapies need to improve drastically before the clinical application of REBOA can be effectively extended to outside the vicinity of specialty centers.
在抵达专科中心进行确定性手术治疗之前，可考虑采用主动脉内复苏球囊阻断术（REBOA）来暂时控制灾难性出血。
我们描述了一名72岁男性的临床病例，该患者患有肾下腹主动脉瘤破裂，最初在外部机构通过REBOA稳定病情后转至我们处接受治疗。转运时间超过100分钟。尽管成功修复了破裂的动脉瘤，但患者因多器官功能衰竭死亡，这可能与主动脉长时间球囊阻断导致的缺血再灌注损伤有关。
在REBOA的临床应用能够有效扩展至专科中心附近区域之外之前，需要大幅改进减轻缺血的技术和疗法。
