一种用于主动脉复苏性血管内球囊阻断术（REBOA）的低轮廓装置的独家临床经验。
Exclusive clinical experience with a lower profile device for resuscitative endovascular balloon occlusion of the aorta (REBOA).
机构信息
University of California Riverside, California, USA.
University of Texas Memorial Hermann Medical Center Texas Trauma Institute, USA.
出版信息
Am J Surg. 2019 Jun;217(6):1126-1129. doi: 10.1016/j.amjsurg.2018.11.029. Epub 2018 Nov 28.
BACKGROUND
A lower profile, FDA-approved device for aortic occlusion (AO) is available for REBOA.
METHODS
Patients who received AO with the new device from February 2016 to February 2017 at 2 urban tertiary care centers were enrolled.
RESULTS
60 consecutive patients underwent REBOA; 44 (73.3%) following blunt trauma. 52 (88.1%) were male; mean age of 40 ± 18 years. 49 REBOAs were deployed in Zone 1, 11 in Zone 3.67.7% of patients in arrest achieved return of spontaneous circulation (ROSC). Overall in-hospital survival was 43%; 19% for patients in arrest and 69% for patients with refractory hypotension. Access and vascular procedural complications included iliac intimal injury requiring stent-graft (1), patch angioplasty of the CFA (1), and balloon ruptures (3). 5 amputations were required; 2 immediate completion amputations due to initial injury, and 3 delayed amputations after efforts to salvage severely mangled extremities were unsuccessful.
CONCLUSION
Smaller introducer sheaths for REBOA are safe and effective but do not eliminate the need for surgical common femoral artery access. Patients can benefit from REBOA with acceptable survival rates.
背景
一种新的、经美国食品和药物管理局批准的、用于主动脉阻塞（AO）的低位设备可用于 REBOA。
方法
2016 年 2 月至 2017 年 2 月期间，在 2 家城市三级保健中心，对接受新设备 AO 的患者进行了研究。
结果
60 例连续患者接受了 REBOA；44 例（73.3%）为钝性创伤。52 例（88.1%）为男性；平均年龄为 40±18 岁。49 例 REBOA 放置在 1 区，11 例放置在 3 区。67.7%的停搏患者实现了自主循环恢复（ROSC）。总体院内生存率为 43%；停搏患者为 19%，难治性低血压患者为 69%。入路和血管操作并发症包括需要支架移植的髂内动脉内膜损伤（1 例）、股总动脉补片血管成形术（1 例）和球囊破裂（3 例）。需要进行 5 例截肢术；2 例为初始损伤导致的即刻完成截肢术，3 例为严重损毁肢体抢救无效后延迟截肢术。
结论
较小的 REBOA 导入鞘是安全有效的，但不能消除对股总动脉手术入路的需求。患者可以从 REBOA 中获益，生存率可接受。
Zotero 插件