Evaluation of Partial Flow Strategies in Hemorrhage and Traumatic Brain Injury with Endovascular Variable Aortic Control

Abstract

Both iREBOA and pREBOA are partial flow strategies, building upon the success of REBOA (complete aortic occlusion) to achieve hemorrhage control and restore hemodynamics in patients with exsanguinating noncompressible truncal hemorrhage. These techniques aim to extend the duration of intervention and minimize ischemia to distal tissue beds prior to definitive surgical hemostasis, particularly in austere military environments. An ideal strategy balances hemodynamic stability to the heart, lungs and brain, while minimizing downstream ischemia. This is especially important in the context of traumatic brain injury (TBI), where brain hypoperfusion is known to result in worse neurologic outcomes. In preliminary studies, pREBOA promotes improved hemodynamic stability through continuous low level downstream blood flow, whereas iREBOA can result in pronounced hemodynamic shifts at the time of balloon deflation. We hypothesize that hemodynamic stability, cerebral perfusion and blood loss utilizing automated pREBOA will be superior to iREBOA.

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Document Details

Document Type
Technical Report
Publication Date
Oct 01, 2021
Accession Number
AD1163342

Entities

People

  • Timothy K. Williams

Organizations

  • Wake Forest University

Tags

DTIC Thesaurus Topics

  • Acquisition
  • Algorithms
  • Animal Experimentation
  • Biomedical Research
  • Blood Flow
  • Brain Injuries
  • Cardiovascular Physiological Phenomena
  • Data Acquisition
  • Data Analysis
  • Demographic Cohorts
  • Experimental Design
  • Hemorrhage
  • Medical Personnel
  • Procurement
  • Simulations
  • Software Development
  • Surgery
  • Universities
  • Vascular System Injuries

Fields of Study

  • Medicine

Readers

  • Neurotrauma and Rehabilitation Medicine.
  • Trauma Surgery or Emergency Medicine.