Intermittent use of resuscitative endovascular balloon occlusion of the aorta in penetrating gunshot wound of the lower extremity

Intermittent use of resuscitative endovascular balloon occlusion of the aorta in penetrating gunshot wound of the lower extremity

Can J Surg 2019;62(6):E9-E12 | PDF

Omar Bekdache, MD; Tiffany Paradis, BSc; David Bracco, MD; Aly Elbahrawy, MD; Kosar Khwaja, MD; Dan L. Deckelbaum, MD; Paola Fata, MD; Andrew Beckett, MD, MSc; Tarek Razek, MD; Jeremy Grushka, MD, MSc

Summary

The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in penetrating injuries is an emerging adjunct in the civilian trauma surgeon’s toolbox for the management of traumatic hemorrhagic shock. Furthermore, within the Canadian civilian context, little has been reported with regard to its use as an assisted damage-control measure in vascular reconstruction of the lower extremity. We report a case of penetrating gunshot injury of the lower extremity where the preoperative deployment of REBOA had a remarkable positive impact in the resuscitation phase and the intraoperative control of blood loss. A description of the procedure and the advantage gained from REBOA are discussed.


Accepted March 5, 2019

Acknowledgements: The authors acknowledge the support of the Montreal General Hospital Foundation, the McGill University Health Centre Emergency Medicine and Adult Trauma Programs.

Affiliations: From the Trauma Program, McGill University Health Centre, Montreal, Que. (Beckett, Bekdache, Bracco, Elbahrawy, Khwaja, Deckelbaum, Fata, Razek, Grushka); the Faculty of Medicine, McGill University, Montreal, Que. (Paradis); the Medical Research Institute, Alexandria University, Alexandria, Egypt (Elbahrawy); and the Royal Canadian Medical Services, Montreal, Que. (Beckett).

Competing interests: D. Deckelbaum and A. Beckett are CJS associate editors. They were not involved in the review of this manuscript or in the decision to accept it for publication. No other competing interests declared.

Contributors: All authors contributed substantially to the conception, writing and revision of this article and approved the final version for publication.

DOI: 10.1503/cjs.017018

Correspondence to: T. Paradis, Montreal General Hospital, 1650 Cedar Ave, Montreal QC H3G 1A4, tiffany.paradis@mail.mcgill.ca