PMID- 27050883
OWN - NLM
STAT- MEDLINE
DCOM- 20170626
LR  - 20220409
IS  - 2163-0763 (Electronic)
IS  - 2163-0755 (Linking)
VI  - 81
IP  - 3
DP  - 2016 Sep
TI  - The AAST prospective Aortic Occlusion for Resuscitation in Trauma and Acute Care 
      Surgery (AORTA) registry: Data on contemporary utilization and outcomes of aortic 
      occlusion and resuscitative balloon occlusion of the aorta (REBOA).
PG  - 409-19
LID - 10.1097/TA.0000000000001079 [doi]
AB  - INTRODUCTION: Aortic occlusion (AO) for resuscitation in traumatic shock remains 
      controversial. Resuscitative endovascular balloon occlusion of the aorta (REBOA) 
      offers an emerging alternative. METHODS: The American Association for the Surgery 
      of Trauma Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery 
      registry prospectively identified trauma patients requiring AO from eight ACS 
      Level 1 centers. Presentation, intervention, and outcome variables were collected 
      and analyzed to compare REBOA and open AO. RESULTS: From November 2013 to 
      February 2015, 114 AO patients were captured (REBOA, 46; open AO, 68); 80.7% were 
      male, and 62.3% were blunt injured. Aortic occlusion occurred in the emergency 
      department (73.7%) or the operating room (26.3%). Hemodynamic improvement after 
      AO was observed in 62.3% [REBOA, 67.4%; open OA, 61.8%); 36.0% achieving 
      stability (systolic blood pressure consistently >90 mm Hg, >5 minutes); REBOA, 22 
      of 46 (47.8%); open OA, 19 of 68 (27.9%); p =0.014]. Resuscitative endovascular 
      balloon occlusion of the aorta (REBOA) access was femoral cut-down (50%); US 
      guided (10.9%) and percutaneous without imaging (28.3%). Deployment was achieved 
      in Zones I (78.6%), II (2.4%), and III (19.0%). A second AO attempt was required 
      in 9.6% [REBOA, 2 of 46 (4.3%); open OA, 9 of 68 (13.2%)]. Complications of REBOA 
      were uncommon (pseudoaneurysm, 2.1%; embolism, 4.3%; limb ischemia, 0%). There 
      was no difference in time to successful AO between REBOA and open procedures 
      (REBOA, 6.6 +/- 5.6 minutes; open OA, 7.2 +/- 15.1; p = 0.842). Overall survival was 
      21.1% (24 of 114), with no significant difference between REBOA and open AO with 
      regard to mortality [REBOA, 28.2% (13 of 46); open OA, 16.1% (11 of 68); p = 
      0.120]. CONCLUSION: Resuscitative endovascular balloon occlusion of the aorta has 
      emerged as a viable alternative to open AO in centers that have developed this 
      capability. Further maturation of the American Association for the Surgery of 
      Trauma Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery 
      database is required to better elucidate optimal indications and outcomes. LEVEL 
      OF EVIDENCE: Therapeutic/care management study, level IV.
FAU - DuBose, Joseph J
AU  - DuBose JJ
AD  - From the David Grant Medical Center (J.J.D.), University of California-Davis, 
      Davis, California; Department of Surgery (T.M.S., M.B.), R Adams Cowley Shock 
      Trauma Center, University of Maryland Medical Center, Baltimore, Maryland; Los 
      Angeles County + University of Southern California Hospital (D.S., K.I.), Los 
      Angeles, California; San Antonio Military Medical Center (J.C.), United States 
      Army Institute of Surgical Research, San Antonio, Texas; University of Texas 
      Health Sciences Center-Houston (L.M., J.H.), Houston, Texas; Loma Linda 
      University Medical Center (D.T., C.N.A.), Loma Linda, California; University of 
      Calgary (A.K., J.X.), Calgary, Alberta, Canada; University of 
      Florida-Jacksonville (D.S.), Jacksonville, Florida; and East Carolina Medical 
      Center (N.P.), New Bern, North Carolina.
FAU - Scalea, Thomas M
AU  - Scalea TM
FAU - Brenner, Megan
AU  - Brenner M
FAU - Skiada, Dimitra
AU  - Skiada D
FAU - Inaba, Kenji
AU  - Inaba K
FAU - Cannon, Jeremy
AU  - Cannon J
FAU - Moore, Laura
AU  - Moore L
FAU - Holcomb, John
AU  - Holcomb J
FAU - Turay, David
AU  - Turay D
FAU - Arbabi, Cassra N
AU  - Arbabi CN
FAU - Kirkpatrick, Andrew
AU  - Kirkpatrick A
FAU - Xiao, James
AU  - Xiao J
FAU - Skarupa, David
AU  - Skarupa D
FAU - Poulin, Nathaniel
AU  - Poulin N
CN  - AAST AORTA Study Group
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PL  - United States
TA  - J Trauma Acute Care Surg
JT  - The journal of trauma and acute care surgery
JID - 101570622
SB  - IM
CIN - J Trauma Acute Care Surg. 2016 Sep;81(3):617-8. PMID: 27270851
CIN - J Trauma Acute Care Surg. 2016 Sep;81(3):617. PMID: 27270852
MH  - Adult
MH  - *Aorta, Abdominal
MH  - *Aorta, Thoracic
MH  - *Balloon Occlusion
MH  - *Endovascular Procedures
MH  - Female
MH  - Hemodynamics
MH  - Hemorrhage/*etiology/*prevention & control
MH  - Humans
MH  - Male
MH  - Prospective Studies
MH  - Registries
MH  - Resuscitation/*methods
MH  - United States
MH  - Wounds and Injuries/*complications
EDAT- 2016/04/07 06:00
MHDA- 2017/06/27 06:00
CRDT- 2016/04/07 06:00
PHST- 2016/04/07 06:00 [entrez]
PHST- 2016/04/07 06:00 [pubmed]
PHST- 2017/06/27 06:00 [medline]
AID - 10.1097/TA.0000000000001079 [doi]
PST - ppublish
SO  - J Trauma Acute Care Surg. 2016 Sep;81(3):409-19. doi: 
      10.1097/TA.0000000000001079.