Resuscitative endovascular balloon occlusion of the aorta: Rupture risk and implications for blind inflation

Philip J. Wasicek, William A. Teeter, Megan L. Brenner, Melanie R. Hoehn, Thomas M. Scalea, Jonathan J. Morrison*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


background Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a torso hemorrhage control technique. To expedite deployment, inflation is frequently performed as a blind technique with minimal imaging, which carries a theoretical risk of aortic injury. The objective of this study was to examine the relationship between balloon inflation, deformation and the risk of aortic rupture. Methods Compliant balloon catheters were incrementally inflated in segments of cadaveric swine aorta. Serial longitudinal and circumferential measurements were recorded, along with the incidence of aortic rupture. results Fourteen cadaveric swine aorta segments were tested with mean (±SD) baseline aortic diameter (mm) of 14.2±3.4. Rupture occurred in three aortas. The mean baseline diameters (mm) of the aortic segments that were ruptured were significantly smaller than those that did not rupture (8.9±1.2 vs 15.6±1.9; P<0.001). The maximal circumferential stretch ratios were significantly higher in the aorta segments that ruptured compared with those that did not (1.9±0.1 vs 1.5±0.1; P<0.001). The maximal amount of balloon longitudinal deformation was 80 mm (116% longer than the intended working length). Conclusions Inflation of aortic balloon catheters carries an inherent risk of aortic injury, which may be minimized through an understanding of the intrinsic characteristics of the aorta and compliant balloons. Smaller diameter aortic segments undergoing overinflation, particularly beyond a circumferential stretch ratio of 1.8, are at risk of aortic ru ture.

Original languageEnglish
Article numbere000141
JournalTrauma Surgery and Acute Care Open
Issue number1
StatePublished - Jan 2018
Externally publishedYes


Dive into the research topics of 'Resuscitative endovascular balloon occlusion of the aorta: Rupture risk and implications for blind inflation'. Together they form a unique fingerprint.

Cite this