Chang Sung Wook, Chun Sangwook, Lee Gyeongho, Seo Pil Won
Trauma Center, Dankook University Hospital, Cheonan, Korea.
Department of Thoracic and Cardiovascular Surgery, Dankook University Hospital, Cheonan, Korea.
J Chest Surg. 2021 Oct 5;54(5):429-432. doi: 10.5090/jcs.20.124.
Isolated iliac artery aneurysm (IAA) is rare, but can be fatal. Emergency surgery is performed in cases of hemorrhagic shock due to a suddenly ruptured IAA, which may have a high mortality rate because of massive non-compressible torso hemorrhage (NCTH). Recently, resuscitative endovascular balloon occlusion of the aorta (REBOA) has been accepted as an alternative to aortic cross-clamping via open thoracotomy to achieve hemostasis in trauma patients with profound shock due to NCTH and is considered an emerging bridging therapy for damage control. However, there is limited information on the use of REBOA in non-trauma patients with shock. Herein, we describe a patient with impending cardiac arrest due to isolated ruptured IAA, in whom perioperative bleeding was successfully controlled by REBOA.
孤立性髂动脉瘤(IAA)较为罕见,但可能致命。对于因IAA突然破裂导致失血性休克的病例,需进行急诊手术,由于大量不可压缩性躯干出血(NCTH),此类手术的死亡率可能较高。最近,复苏性血管内主动脉球囊阻断术(REBOA)已被认可为一种替代通过开胸进行主动脉交叉钳夹的方法,用于因NCTH导致严重休克的创伤患者实现止血,并且被视为一种新兴的损伤控制桥接治疗方法。然而,关于REBOA在非创伤性休克患者中的应用信息有限。在此,我们描述了一名因孤立性破裂IAA而即将发生心脏骤停的患者,其围手术期出血通过REBOA成功得到控制。