title: Emerging Endovascular Therapies for Non-Compressible Torso Hemorrhage.
abstract: Management of non-compressible torso hemorrhage (NCTH) remains a challenge despite continued advancements in trauma resuscitation. Resuscitative thoracotomy with aortic cross-clamping and recent advances in endovascular aortic occlusion, including resuscitative endovascular occlusion of the aorta, have finite durations of therapy due to the inherent physiologic stressors that accompany complete occlusion. Here, we attempt to illuminate the current state of aortic occlusion for trauma resuscitation including explanation of the deleterious consequences of complete occlusion, potential methods and limitations of existing technology to overcome these consequences, and a description of innovative methods to improve the resuscitation of NCTH. By explaining the complexity and potential deleterious effects of resuscitation augmented with aortic occlusion, our goal is to provide practitioners with a real-world perspective on current endovascular technology and to encourage the continued innovation required to overcome existing obstacles.
authors.affiliation: *Department of Surgery, UC Davis Medical Center, Sacramento, California †Department of General Surgery, David Grant USAF Medical Center, Travis Air Force Base, California ‡Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland §Department of Emergency Medicine, University of California Davis Medical Center, Sacramento, California ||Department of Vascular and Endovascular Surgery, David Grant USAF Medical Center, Travis Air Force Base, California.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Russo
authors.forename: Lucas P
authors.initials: LP
authors.lastname: Neff
authors.forename: Michael Austin
authors.initials: MA
authors.lastname: Johnson
authors.forename: Timothy K
authors.initials: TK
authors.lastname: Williams
mesh_terms: D001013:Aorta, Thoracic / Q000293:injuries / Q000601:surgery; D021721:Balloon Occlusion / Q000379:methods; D006470:Hemorrhage / Q000601:surgery* / Q000628:therapy*; D006801:Humans; D012151:Resuscitation / Q000379:methods; D012771:Shock, Hemorrhagic / Q000601:surgery / Q000628:therapy; D016896:Treatment Outcome