Computed tomography imaging of resuscitative endovascular balloon occlusion of the aorta (REBOA): pearls and pitfalls

Ryo Aoki,Daisuke Utsunomiya,Shintaro Nawata,Yusuke Kobayashi,Hiroyuki Kamide,Zenjiro Sekikawa,Shintaro Furugori,Toh Yamamoto

doi:10.1007/s11604-021-01166-w

Abstract

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed in patients with hemorrhagic shock who develop massive subdiaphragmatic bleeding. This procedure enables rapid and less invasive aortic blockade compared to resuscitative thoracotomy and aortic cross-clamp procedures. However, the REBOA procedure is often blindly performed in the emergency department without fluoroscopy, and the appropriateness of the procedure may be evaluated on computed tomography (CT) after REBOA. Therefore, radiologists should be familiar with the imaging features of REBOA. We present a pictorial review of the radiological findings of REBOA along with a description of the procedure, its complications, and pitfalls.

Highlights

High-energy trauma is defined as open or closed injuries caused by forces
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a resuscitation procedure in which a balloon catheter is inserted into the aorta to create a balloon blockade that increases proximal arterial pressure to maintain central organ perfusion while controlling distal subdiaphragmatic hemorrhage [2]
The REBOA procedure is performed under guidance by fluoroscopy and/ or ultrasound for appropriate placement without complications

Summary

Introduction

High-energy trauma is defined as open or closed injuries caused by forces (e.g., motor vehicle accidents). Keywords Resuscitative endovascular balloon occlusion of the aorta · Computed tomography · Complications · Pitfalls Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a resuscitation procedure in which a balloon catheter is inserted into the aorta to create a balloon blockade that increases proximal arterial pressure to maintain central organ perfusion while controlling distal subdiaphragmatic hemorrhage [2]. The REBOA procedure is performed under guidance by fluoroscopy and/ or ultrasound for appropriate placement without complications. 2 Diagnostic Radiology, Yokohama City University Medical Center, Yokohama‐shi, Kanagawa, Japan

Results

Conclusion