Gastroesophageal Resuscitative Occlusion of the Aorta (GROA)
Technical Report,01 Feb 2019,31 Jan 2020
University of Michigan Ann Arbor United States
Pagination or Media Count:
Natural Orifice Transluminal Endoscopic Surgery NOTES is an evolving surgical innovation, which allows for intra-cavitary surgeries to be performed with an endoscope passed through a natural orifice mouth anus, vagina, urethra. It is the purpose of this proposal to leverage the concept of NOTES to develop a method of temporary aortic occlusion using an orally placed gastroesophageal device. This gastroesophagealresuscitative occlusion of the aorta GROA will be developed as a field bridge to more invasive and definitive means of control of non-compressible torso hemorrhage NCTH such as resuscitative endovascular balloon occlusion of the aorta REBOA, angiography, and surgery.Hypothesis The anatomical relationship between the esophagus and stomach to the descending thoracic and abdominal aorta will allow complete mechanical occlusion of the aorta through the stomach that can prolong short-term survival of severe NCTH. Specific AimsObjectives 1 Design and prototype GROA devices that can be orally placed into the stomach that mechanically produces complete occlusion of the aorta at or above the celiac artery and test the physiologic tolerance of GROA in comparison to REBOA in swine undergoing hemorrhage. 2 Test and compare GROA prototypes to REBOA for staunching severe NCTH in a large swine animal model of traumatic shock. 3 Demonstrate tandem use of GROA followed by REBOA as an example of point-of-care in field prolonged field care PFC and prolonged damage control resuscitation pDCR in a swine model of severe NCTH. Experimental Approach An iterative design and testing approach will be taken to develop a product, which leverages the anatomical relationship of the esophagus and stomach to the descending thoracic and abdominal aorta.
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