Transfemoral temporary aortic balloon occlusion assisting open repair for ruptured abdominal aortic aneurysms.
The mortality rate of ruptured abdominal aortic aneurysm (rAAA) is still high despite an advance in surgical technology and critical care. The authors report three patients who had successful open repairs of rAAA assisted by transfemoral temporary aortic balloon occlusion. Before the operation, these patients had severe abdominal pain with hypotension. An aortic balloon occlusion catheter was introduced into the abdominal aorta under fluoroscopy at pararenal level, which was accessed from the right common femoral artery under local anesthesia. After balloon inflation, a rapid increase in arterial blood pressure was found and general anesthetic induction was started. Finally, open repair of rAAA was successfully carried out with rapid proximal neck control by aortic balloon palpation. All the patients made an uneventful recovery during the postoperative period and were discharged on day 16, day 8, and day 17 respectively.


CONCLUSIONS
Transfemoral temporary aortic balloon occlusion is an effective strategy in rapid proximal aortic control before a conventional open repair of rAAA. It provides immediate hemostasis resulting in stabilized blood pressure before and during anesthetic induction, and facilitated aortic neck identification.
Division of Vascular Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Chumpol
C
Wongwanit
Pramook
P
Mutirangura
Khamin
K
Chinsakchai
Chanean
C
Ruangsetakit
Nuttawut
N
Sermsathanasawadi
Kiattisak
K
Hongku
Suteekhanit
S
Hahtapornsawan
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D021721:Balloon Occlusion; D019917:Blood Vessel Prosthesis Implantation; D006801:Humans; D008297:Male