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Evaluating the use of Resuscitative Endovascular Balloon Occlusion of the Vena Cava (REBOVC) in Retrohepatic Vena Cava Injuries: Indications Technical Aspects and Outcomes
Aim: Vena cava injuries are a major challenge for trauma surgeons due to their difficult-to-access anatomical site.In addition, their complex operative management often requires prohibitive time for damage control purposes.Considering this scenario, endovascular techniques, such as endovascular occlusion devices, have been increasingly applied to treat such injuries.Resuscitative endovascular balloon occlusion of the vena cava (REBOVC) stands out as a promising technique to manage hemodynamically unstable patients -depending on the anatomical site of the injuries and the complexity of the access to them-since it enables temporary bleeding control to stabilize patients' conditions.Methods: Based on a literature review about the use of REBOVC to manage venous bleeding deriving from the inferior vena cava (IVC).Four experimental studies were conducted with animal models, one descriptive study about the principles of occlusion in artificial models and four case reports were evaluated.Results: REBOVC helped shorten the time necessary for bleeding control and increased the likelihood of achieving effective treatment in cases of potentially lethal bleeding, as well as reduced mortality rates.Conclusion: REBOVC is a promising endovascular technique that can be used in a safer and more objective way to promote a new paradigm in IVC trauma scenarios to help to control bleeding and reduce its consequences.
Tópico:
Trauma, Hemostasis, Coagulopathy, Resuscitation
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FuentePanamerican Journal of Trauma Critical Care & Emergency Surgery