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Case Reports
. 2019 Dec 1;62(6):E9-E12.
doi: 10.1503/cjs.017018.

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

Omar Bekdache  1 , Tiffany Paradis  1 , David Bracco  1 , Aly Elbahrawy  1 , Kosar Khwaja  1 , Dan L. Deckelbaum  1 , Paola Fata  1 , Andrew Beckett  1 , Tarek Razek  1 , Jeremy Grushka  1
Affiliations
Case Reports

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

Omar Bekdache et al. Can J Surg. .

Abstract

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.

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Conflict of interest statement

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.

Figures

Fig. 1
Fig. 1
Preoperative radiograph showing a comminuted fracture of the right femur and shrapnel from the ballistic injury. The medial aperture is marked with a metallic paper clip.
Fig. 2
Fig. 2
A) Intraoperative picture of the shunted superficial femoral artery. B) Resuscitative endovascular balloon occlusion of the aorta catheter shown accessing the left groin. Note the shunted vessel and the deformed, swollen thigh.
Fig. 3
Fig. 3
Definitive interval orthopedic fixation with intramedullary interlocking nail. Note the metallic clips marking the medial initial approach.
Fig. 4
Fig. 4
Postoperative wound left open for gradual bedside tightening.
See this image and copyright information in PMC

References

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