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Partial Resuscitative Endovascular Balloon Occlusion of the Aorta (P-REBOA) in a Pig Model (Sus scrota)

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Technical Report

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60 MDG CIF Travis AFB United States

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Objectives We investigated the hemodynamic and physiologic effects of partial Resuscitative Endovascular Balloon Occlusion of the Aorta REBOA versus the current practiced complete REBOA c-REBOA technique. Methods Fifteen Yorkshire-cross swine were subjected to 25 total blood volume loss. They were randomized to either c-REBOA, p-REBOA, or no intervention. Aortic pressures, visceral arterial pressures, and serum makers of ischemia were recorded throughout the experiment. P-REBOA was achieved by inflating the balloon catheter to generate a 50 pressure gradient across the balloon. Following balloon deflation, the experiment continued for 15 minutes to evaluate the effects of reperfusion. End organs were histologically examined. Results Compared with no treatment, c-REBOA produced considerable increases in central aortic pressure after hemorrhage but also substantially higher levels of serum lactate, followed by a precipitous drop in blood pressures on balloon deflation. p-REBOA resulted in hemodynamic effects that were superior to control while maintaining a similar lactate profile. Histological analysis of intestinal mucosa revealed early necrosis and disruption of the villi with c-REBOA, but not in the p-REBOA and control group. Conclusion p-REBOA may minimize the systemic physiologic insult and damage to tissues distal to the balloon .

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  • Anatomy and Physiology
  • Medicine and Medical Research

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