A retrospective capability gap analysis of the UK Joint Theatre Trauma Registry suggested that as many as one in five severely injured casualties have wounds that may be amenable to treatment with REBOA.⁶⁵ The development of the 4 Fr COBRA-OS® , 7 Fr ER REBOA-Plus™ catheter and subsequent versions facilitates insertion of the device and may lead to more widespread use of this approach in the austere environment. Specifically, the development of the novel semi compliant pREBOA-PRO™ catheter extends occlusion time and decreased management of the balloon volume.³⁹ The feasibility of training non-physician caregivers to place REBOAs in the prehospital settings is being investigated.^66-67 Research is currently being conducted to improve visualization tools regarding cannulation and targeted training of medical providers. Partial REBOA, intermittent REBOA, regional hypothermia, and pharmacologic adjuncts continue to undergo validation as a means of prolonging aortic occlusion time.^68,69,70,78 Future animal studies with realistic models of injury are being developed to provide detailed multisystem organ assessment to accurately define organ injury and metabolic burden associated with prolonged partial REBOA application.⁷¹ Ongoing research seeks to identify modifications to the REBOA technique that may be required when it is combined with other resuscitation modalities such as tranexamic acid. Researchers are also striving to clarify patient selection, evaluating the impact of REBOA on thoracic injury, and traumatic brain injury.⁷² All of these advances should refine the optimal use of this resuscitation adjunct. Longitudinal data in the civilian and military setting will assist in defining the ideal clinical situation in which REBOA can be of maximal benefit.