Just in time for trauma season, doctors at Trinity Health have adopted a new technique that can stop fatal bleeding with a simple balloon device.
Dr. Gary Wease, a general surgeon and director of Trinity’s Trauma Program, says the ER-REBOA™ Catheter is now available to surgeons and emergency physicians as a lifesaving tool in cases where patients are at risk of bleeding to death due to massive blood loss that can’t be stopped with compression.
“Acute internal hemorrhage is the leading cause of death in trauma patients,” Dr. Wease noted. “The sooner we can intervene, the better. With the REBOA, we have a less invasive way to achieve immediate hemorrhage control so the patient can be stabilized and sent to the OR for definitive treatment.”
Traditionally, the only option doctors had to stop uncontrolled bleeding was to perform a thoracotomy, a major surgery that involves making a large chest incision, opening the rib cage, and putting a clamp on the aorta – the body’s main artery. What the ER-REBOA™ Catheter offers is a minimally invasive alternative to this method, using a technology similar to the technique cardiologists use to open arteries of the heart.
“Basically, the REBOA is a catheter with a collapsed balloon at its tip,” Dr. Wease explains. “The catheter is inserted into the femoral artery of the leg and threaded up into the aorta. Once the balloon has reached the optimal spot, it’s inflated, causing a temporary blockage of the aorta.”
REBOA stands for Resuscitative Endovascular Balloon Occlusion of the Aorta. It’s the flagship product of Prytime Medical Devices, Inc., headquartered in San Antonio, TX. The company designs, develops and commercializes minimally invasive solutions for vascular trauma. Kari Mogen, a clinical specialist with the company, says, not surprisingly, the ER-REBOA™ device has its origins in military medicine.
“The underlying intellectual property for the ER-REBOA™ Catheter came from two military surgeons, Colonel Todd Rasmussen, MD, and Dr. Jonathan Eliason, and is based on their wartime experiences,” Mogen said. “But the concept of occluding large arteries to stop hemorrhage dates back even further to the Korean War, when war surgeons looked for ways to save more lives on the battlefield.”
Mogen says the ER-REBOA™ Catheter is designed and indicated for temporary occlusion of large vessels and blood pressure monitoring, including patients requiring emergency control of hemorrhage. For patients with truncal hemorrhage (affecting the trunk of the body), REBOA helps maintain blood flow to critical organs like the heart and brain until the hemorrhage can be definitively controlled via surgery.
In February, Trinity’s emergency, critical care, and anesthesia staff received training in the REBOA technique. Trinity Health is now the first North Dakota hospital and one of nearly 250 worldwide to enhance its trauma arsenal with the device. Dr. Wease says it should come in handy during the upcoming trauma months that fall between Memorial Day and Labor Day.
“We get some nasty accidents and motorcycle crashes during a busy trauma season,” Dr. Wease said. “I can see us using it two or three times, maybe more. The key thing is – you have to use it proactively. So there may be times when we’ll put the balloon in place and not inflate it, which is fine. It’s better than opening the chest and clamping an aorta.”