RESUMO
: Hemorrhage is the leading cause of preventable death in trauma patients. In recent years, technological innovations and research efforts aimed at preventing death from hemorrhagic shock have resulted in the emergence of resuscitative endovascular balloon occlusion of the aorta (REBOA). REBOA offers a less invasive option for emergent hemorrhage control in noncompressible areas of the body without the added risks and morbidities of an ED thoracotomy. This article outlines the procedure and device used, describes the procedure's evolution, and discusses various considerations, pitfalls, and nursing implications.
Assuntos
Aorta/lesões , Aorta/cirurgia , Oclusão com Balão/métodos , Ressuscitação/enfermagem , Choque Hemorrágico/enfermagem , Choque Hemorrágico/terapia , Oclusão com Balão/história , Oclusão com Balão/enfermagem , Cateterismo Periférico/métodos , Cateterismo Periférico/enfermagem , Feminino , História do Século XX , História do Século XXI , Humanos , Pessoa de Meia-Idade , Choque Hemorrágico/etiologia , Ferimentos e Lesões/complicações , Ferimentos e Lesões/terapiaRESUMO
A 29-year-old female with a history of relapsing polychondritis (RP) and open repair of a proximal descending thoracic aneurysm presented with 2 areas of asymptomatic thoracic aortic aneurysmal dilatation. The patient returned 3 months later with symptomatic aneurysm expansion, and she underwent ascending aortic arch replacement. She subsequently underwent staged endovascular repair of the distal descending thoracic aorta. RP is a rare disorder with an incidence of 3.5 per million persons annually, 4% to 7% of whom develop aneurysmal disease. Because of the aneurysmal potential of this disease, it is important for vascular surgeons to be aware of its presentation and treatment. To our knowledge, this is the first reported case describing endovascular technique to treat such a patient.