ArticleTrauma surgery & acute care open2021
When the balloon goes up, blood transfusion goes down: a pilot study of REBOA in placenta accreta spectrum disorders.
Article in Trauma surgery & acute care open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Abdominal Aorta Balloon Occlusion Versus Standard Care in Placenta Accreta Spectrum Disorder: A Randomized Controlled Trial.Life (Basel, Switzerland) · 2026Article
- Every minute counts: a network meta-analysis comparing the effect of prophylactic endovascular procedures in abnormal placentation.World journal of emergency surgery : WJES · 2025Article
- Effectiveness of aortic balloon occlusion in reducing blood loss during cesarean section in placenta accreta spectrum disorders: a study protocol for a randomized controlled trial.Frontiers in medicine · 2025Article
- Resuscitative Endovascular Balloon Occlusion of the Aorta in surgical and trauma patients: a systematic review, meta-analysis and practice management guideline from the Eastern Association for the Surgery of Trauma.Trauma surgery & acute care open · 2025Article
- [Resuscitative endovascular balloon occlusion of the aorta (REBOA) for cesarean section in two patients with placenta accreta spectrum disorder].Die Anaesthesiologie · 2024Article
- Primary and secondary postpartum haemorrhage: a review for a rationale endovascular approach.CVIR endovascular · 2024Review
- Serum exosomal microRNA pathway activation in placenta accreta spectrum: pathophysiology and detection.AJOG global reports · 2024Article
- Placenta Accreta Spectrum: The Role of Interventional Radiology in Multidisciplinary Management.Seminars in interventional radiology · 2023Review
- The use of Resuscitative Endovascular Balloon Occlusion of the Aorta in a pregnant woman with a ruptured splenic aneurysm and haemorrhagic shock: A case report.Acta anaesthesiologica Scandinavica · 2023Article
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Authors and funding
7 authors.
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Abstract
backgroundPatients with placenta accreta spectrum (PAS) disorders often suffer massive hemorrhage during cesarean hysterectomies (CHyst). A novel strategy to decrease blood loss and minimize perioperative morbidity associated with PAS is utilization of ER-REBOA Catheter intraoperatively. In this study, we explore the use of ER-REBOA Catheter during CHyst with the goal of minimizing perioperative morbidity and packed red blood cell (PRBC) transfusions.
methodsWe conducted a retrospective case-control study at a regional referral center of consecutive patients with PAS undergoing CHyst. The primary outcomes were PRBC transfusions of ≥4 units. Secondary outcomes included surgical intensive care unit admissions, postoperative length of stay (LOS), postoperative ileus, and vascular complication rate. We also explored utilization of manual palpation and omission of precesarean fluoroscopy for resuscitative endovascular balloon occlusion of the aorta (REBOA) placement verification in distal aortic zone 3.
results90 patients were included in the study. REBOA and non-REBOA cases were similar in clinicodemographic characteristics. 17.7% of REBOA cases received ≥4 units of PRBC compared with 49.3% of non-REBOA cases (p=0.03). Zero REBOA patients developed postoperative ileus, whereas 18 (25%) non-REBOA patients did (p=0.02). LOS was reduced in the REBOA group. Postplacement fluoroscopy was omitted in all REBOA cases. Two postoperative arterial thrombotic events (2 of 19, 11% of REBOA patients) were identified in the REBOA group, one requiring a thrombectomy (1 of 19, 5%). DISCUSSION: Decrease in blood transfusions of ≥4 units of PRBC is demonstrated when ER-REBOA Catheter is placed in distal aortic zone 3 during CHyst performed for severe PAS disorders. The incidence of postoperative ileus and LOS are reduced in the ER-REBOA Catheter group. Placement and utilization of ER-REBOA Catheter during CHyst may be feasible without fluoroscopy when manual placement verification is performed by an experienced operator. Protocol modifications focusing on reducing thrombotic rate are ongoing. LEVEL OF EVIDENCE: IV.
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