title: Prospective evaluation of the correlation between torso height and aortic anatomy in respect of a fluoroscopy free aortic balloon occlusion system.
abstract: BACKGROUND
  To report the lengths of key torso vascular and to develop regression models that will predict these lengths, based on an external measure of torso height (EMTH, sternum to pubis) in the development of a fluoroscopy-free balloon occlusion system for hemorrhage control.
  
  
  METHODS
  We conducted a prospective, observational study at a Combat Support Hospital in Southern Afghanistan using adult male patients undergoing computed tomography (CT). EMTH was recorded using a tape measure and intra-arterial distance was derived from CT imaging. Regression models to predict distance from the common femoral artery (CFA) into the middle of aortic zone I (left subclavian artery to celiac trunk) and zone III (infrarenal aorta) were developed from a random 20% of the cohort and validated by the remaining 80%.
  
  
  RESULTS
  Overall, 177 male patients were included with a median (interquartile range [IQR]) age of 23 (8) years. The median (IQR) lengths of aortic zone I and III were 222 (24), 31 (9), and 92 (15) mm. The mid-zone distance from the left and right CFA to zone I were 423 (27) and 418 (29) and for zone III 232 (21) and 228 (22). Linear regression models demonstrated an accuracy between 99.3% to 100% at predicting the insertion distance required to place a catheter within the middle of each aortic zone.
  
  
  CONCLUSIONS
  This study demonstrates the use of morphometric analysis in the development of a fluoroscopy-free balloon occlusion system for torso hemorrhage control. Further study in a larger population of mixed gender is required to further validate insertion models.
authors.affiliation: The Academic Department of Military Surgery & Trauma, Royal Centre for Defence Medicine, Birmingham, UK; The United States Army Institute of Surgical Research, Fort Sam Houston, TX; Academic Unit of Surgery, Glasgow Royal Infirmary, Glasgow, UK.
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Morrison
authors.affiliation: The Academic Department of Military Surgery & Trauma, Royal Centre for Defence Medicine, Birmingham, UK.
authors.forename: Adam
authors.initials: A
authors.lastname: Stannard
authors.affiliation: The Academic Department of Military Surgery & Trauma, Royal Centre for Defence Medicine, Birmingham, UK.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Midwinter
authors.affiliation: Air Force Medical Support Agency, Joint Base San Antonio-Lackland, TX.
authors.forename: Danny J
authors.initials: DJ
authors.lastname: Sharon
authors.affiliation: The Division of Vascular Surgery, University of Michigan, Ann Arbor, MI.
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Eliason
authors.affiliation: The United States Army Institute of Surgical Research, Fort Sam Houston, TX; 59th Medical Wing, Joint Base San Antonio-Lackland, TX; The Norman M. Rich Department of Surgery, the Uniformed Services University of the Health Sciences, Bethesda, MD. Electronic address: todd.e.rasmussen.mil@mail.mil.
authors.forename: Todd E
authors.initials: TE
authors.lastname: Rasmussen
mesh_terms: D000293:Adolescent; D000328:Adult; D001011:Aorta / Q000033:anatomy & histology*; D001027:Aortography; D021721:Balloon Occlusion; D049628:Body Size; D003661:Decision Support Techniques; D006470:Hemorrhage / Q000628:therapy*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D060726:Torso / Q000033:anatomy & histology*; D055815:Young Adult