Trans-abdominal Aortic Occlusion

The aorta can also be occluded trans-abdominally at any point along its length. It can be occluded with either application of a clamp, or compression with a retractor or the surgeon’s hand. Alternatively, if there is limited surgical assistance or a need to reduce the number of instruments in the upper abdomen, a balloon aortic occlusion at Zone 1 or Zone 3 can be considered, depending on where the focus of bleeding is located.

As with all other forms of RAO, restoration of aortic perfusion should be carefully coordinated with the rest of the team to minimize the effects of reperfusion and blood volume shifts.

It should be noted that reperfusion after partial balloon occlusion can occur with gradual titration of volume while monitoring the response of above and below balloon pressures over 10 - 30 minutes to minimize negative hemodynamic consequences during reperfusion. With complete occlusion REBOA catheters, it is not possible to gradually titrate stable reperfusion as the balloon configuration essentially provides “all or none” occlusion.