Resuscitative Thoracotomy and Aortic Cross-Clamp and Resuscitative Endovascular Balloon Occlusion of the Aorta

Abstract

In traumatic hemorrhagic shock, there are situations where rapid aortic occlusion is required. In such cases, the best aortic occlusion should be determined based on the situation. Therefore, it is essential to understand the various types of aortic occlusion, their characteristics, and their indications. However, aortic occlusion is not hemostasis but temporary proximal control of arterial bleeding; definitive hemostasis should not be delayed even if blood pressure is elevated after aortic occlusion. We describe the indications, characteristics and implementation of each aortic occlusion and the comparison between resuscitative thoracotomy with aortic cross-clamp (RTACC) and resuscitative endovascular balloon occlusion of the aorta (REBOA). It is not necessary to discuss the superiority or inferiority of RTACC and REBOA. The appropriate determination of a combination of these tactics will increase the range of strategies and tactics.