Background and Objective: Major cause of trauma
death worldwide is from non-compressible torso
hemorrhage. Currently, Resuscitative Endovascular
Balloon Occlusion of the Aorta (REBOA) plays role in
control of intraabdominal bleeding. Therefore, it is
necessary to use several methods to confirm the
position of the balloon precisely, such as fluoroscopy.
But most hospitals in Thailand do not support
fluoroscopic machine in ER. This study aimed to
determine the intravascular length for placement
REBOA and compare to the appropriate locations of
external landmarks of the body.
Method: Human cadaveric study, external anatomical
(sternal notch, xyphoid process and umbilicus) and
intravascular (left subclavian artery (LSA), celiac trunk
(CT), lowest renal artery (LRA) and aortic bifurcation
(AB)) landmarks from puncture sites. The landing zones
were calculated with intravascular landmarks.
Results: Twenty-two cadavers were analyzed. Mean
external landmarks from right groin to umbilicus,
xyphoid, sternal notch were 19.20, 32.26, 53.42 cm.
and from left groin were 19.25, 32.62, 53.65 cm. The
mean intravascular distance from right puncture site
to AB, LRA, CT, LSA were 21.37, 30.47, 33.95, 55.97
cm. and from left puncture site were 20.69, 29.72,
32.87, 56.20 cm. There are statistically significant of
clinical correlations between external and
intravascular length of right groin - umbilicus with right puncture site - AB (p=0.0385) and right groin - sternal
notch with right puncture site - LSA root (p=0.303).
Conclusion: The use of external anatomical landmarks
to estimate length of REBOA in Zone-1 and Zone-3
with evaluate the clinical response is safe to perform
the procedure.