Femoral Arterial Closure After REBOA using the Fascia Suture Technique: First Experiences in a Military Setting

Abstract

Femoral vascular closure after REBOA can be challenging, and large-caliber sheaths combined with acute traumatic coagulopathy may lead to serious bleeding complications. The Fascia Suture Technique (FST) has been proposed as a safe easy-to-use and cheap method for reliable vascular closure. We present two cases of critically unstable patients for whom this technique was successfully used after REBOA placement through 8 Fr and 10 Fr sheaths at a Role 2 medical treatment facility. In one case, the FST was used for closure of both the femoral artery and vein. The femoral vascular closure took 6–7 minutes for each procedure (in both cases). No additional sutures were needed before reliable hemostasis was achieved. No hematoma or any other complication was noted during air transportation or afterward during a 6-month follow-up period. This report demonstrates the feasibility and effectiveness of using the FST in austere environments.