PMID- 19282811
OWN - NLM
STAT- MEDLINE
DCOM- 20091029
LR  - 20161125
IS  - 0021-9509 (Print)
IS  - 0021-9509 (Linking)
VI  - 50
IP  - 3
DP  - 2009 Jun
TI  - Endovascular proximal control of ruptured abdominal aortic aneurysms: the 
      internal aortic clamp.
PG  - 381-5
AB  - Ruptured abdominal aortic aneurysm (RAAA) is the most common and devastating 
      complication affecting a patient with abdominal aortic aneurysm (AAA). Despite 
      advances in surgery and critical care, the mortality rate associated with RAAA 
      remains largely unchanged. Emergency open repair is the gold standard 
      conventional treatment of RAAA but is associated with a high mortality rate. The 
      physiologic challenges associated with general anaesthetic induction such as loss 
      of the sympathetic vasoconstrictor tone with consequent hypotension, and the 
      anatomic challenges associated with external aortic cross-clamping such as 
      calcification, friability, or poor visualisation of the aneurysm neck, have led 
      to the adoption of endovascular techniques in the surgical treatment of RAAA. 
      Promising results of endovascular repair of ruptured abdominal aortic aneurysm 
      (REVAR) have been reported. In addition, the provision of endovascular aortic 
      control by inflating a compliant aortic occlusion balloon (AOB) proximal to the 
      ruptured aneurysm, as an internal aortic clamp, has been successfully used in 
      haemodynamically unstable patients undergoing either REVAR or emergency open 
      repair of RAAA. An AOB is inserted under local anaesthesia and can be introduced 
      through either the transbrachial or the transfemoral routes, each with its own 
      advantages and disadvantages. This review aimed at providing an up-to-date 
      overview of the current knowledge concerning endovascular proximal aortic control 
      using an AOB with emphasis on the rationale, position, benefits, and drawbacks of 
      its use.
FAU - Assar, A N
AU  - Assar AN
AD  - Division of Vascular and Endovascular Surgery, Stanford, University Medical 
      Center Stanford, CA, USA. assar@stanford.edu
FAU - Zarins, C K
AU  - Zarins CK
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20090312
PL  - Italy
TA  - J Cardiovasc Surg (Torino)
JT  - The Journal of cardiovascular surgery
JID - 0066127
SB  - IM
MH  - Aorta, Abdominal/diagnostic imaging/physiopathology/*surgery
MH  - Aortic Aneurysm, Abdominal/diagnostic imaging/physiopathology/*surgery
MH  - Aortic Rupture/diagnostic imaging/physiopathology/*surgery
MH  - *Balloon Occlusion
MH  - Constriction
MH  - Emergency Treatment
MH  - Hemodynamics
MH  - Humans
MH  - Radiography
MH  - Treatment Outcome
MH  - *Vascular Surgical Procedures
RF  - 23
EDAT- 2009/03/14 09:00
MHDA- 2009/10/30 06:00
CRDT- 2009/03/14 09:00
PHST- 2009/03/14 09:00 [entrez]
PHST- 2009/03/14 09:00 [pubmed]
PHST- 2009/10/30 06:00 [medline]
AID - R37095742 [pii]
PST - ppublish
SO  - J Cardiovasc Surg (Torino). 2009 Jun;50(3):381-5. Epub 2009 Mar 12.