Abstract
Resucitative endovascular balloon occlusion of the aorta (REBOA) is a strategy for proximal hemorrhage control and resuscitation that has been readopted in recent years at several trauma centers for both traumatic and nontraumatic hemorrhage. In select patients, it is an endovascular alternative to resucitative thoracotomy (RT) with the added flexibility of occluding the aorta both in the thoracic aorta and the infrarenal aorta without opening the chest or abdomen. This strategy allows for temporary proximal hemorrhage control buying time for definitive hemostasis while preserving perfusion to critical organs. While there are clinical trials ongoing, high-grade evidence is limited. The critical components of REBOA include patient selection, procedural steps, and complication identification and management. This chapter describes the historical origins of this technique and its contemporary form, reviews the available literature, and provides an overview of the technique complete with pitfalls. We believe that providers with training and solid understanding of REBOA can utilize this tool successfully in caring for select patients in shock. Future clinical experience will help provide more succinct clinical recommendations for use.