01:20am Sunday 20 October 2019

Trusted vascular technique offers patients with multiple traumas better chance of survival



  (Photo by Yuri Markarov)

Dr. Sandro Rizoli holds a tube with the balloon that helps to block blood flow at the bleeding pointPatients who have experienced multiple traumas now have a better chance of survival and a faster recovery thanks to a technique that was used for the first time in Canada on a trauma patient at St. Michael’s.

The procedure is called Resuscitative Endovascular Balloon Occlusion of the Aorta, and it can be used on trauma patients who are experiencing life-threatening bleeding.

Using a series of guide wires, a thin plastic tube with a balloon at the end is fed through a vessel in the groin to the patient’s aorta, the main blood vessel that supplies the body. It is positioned upstream of the bleeding point. Once in place, the balloon is inflated, blocking the blood flow to the bleed point, stemming the blood flow and bleeding while the patient is being resuscitated and operated on.

Often, patients are bleeding so much they aren’t able to make it to the operating room in time. REBOA helps to stop the bleeding quickly, getting the patient to the operating room and on the road to recovery, faster.

      Facts and figures: REBOA

  • This technique was first described more than 50 years ago during the Korean War for injured soldiers
  • It’s a minimally invasive method
  • According to the BBC, a crew from London’s Air Ambulance was the first to use REBOA to control life-threatening bleeding at the roadside

Before REBOA, surgeons such as Dr. Sandro Rizoli, director of trauma, would perform thoracic surgery, opening the chest wall to put a clamp on the aorta to stop the bleeding – exposing the heart and lungs. Now, surgeons can make an incision in the groin to insert the balloon – a much less invasive procedure. An X-ray is used to ensure the balloon is inserted and placed properly.

Members of the vascular, interventional radiology and trauma teams used the technique on a trauma patient for the first time in October.

The technique is familiar to vascular surgeons, where it is used for patients undergoing surgery to repair aortic aneurysms , said Dr. Mark Wheatcroft, the vascular and endovascular surgeon who participated in the pioneering procedure.

“The beauty lies in its speed and simplicity,” he said.

Dr. Rizoli said this approach benefits patients who otherwise may not stand a strong chance at survival.

“Anywhere from 40 to 50 people come in every year with massive bleeding, and this technique will give some of them a chance of survival and rapid recovery,” he said.

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

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