BMC Emerg Med. 2025 Nov 22. doi: 10.1186/s12873-025-01417-3. Online ahead of print.

PURPOSE: The use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for temporary bleeding control in severely injured patients remains controversial. Epidemiological data from Germany, Austria and Switzerland are lacking. The objective of this study was therefore to collect data on the use of REBOA intervention and the characteristics of the affected patient population.

METHODS: A retrospective analysis of the TraumaRegister DGU^® between January 2020 and December 2022 was conducted to evaluate the frequency of REBOA interventions, injury patterns, injury severity, epidemiology and additional therapies received by patients treated with REBOA.

RESULTS: Between 2020 and 2022, 95,510 patients were documented in Germany, Austria and Switzerland (DACH), of whom 62 received REBOA. 44 of 62 patients (71%) were under 60 years of age and 57 (92%) suffered a blunt trauma. Severe injury (AIS ≥ 3) was present in the following regions: head 36%, thorax 77%, abdomen 58%, extremities 65%. 23 of 59 patients (39%) did not have a systolic blood pressure ≤ 90 mmHg. Of the 62 patients, 42 (68%) received at least one unit of packed red blood cells (PRBC), and 24 (39%) received ≥ 10 PRBCs within the first 48 h. Thoracotomy was performed in nine patients (15%), laparotomy in 24 (39%), and 15 (23%) underwent surgical pelvic stabilisation. The expected mortality according to the RISC II score was 43%, while the observed mortality was 45%. Fourteen REBOAs (22%) were performed at one centre; two centres conducted six (10%) and seven (11%) procedures, and 27 centres performed a single REBOA within the three-year period.

CONCLUSION: The use of REBOA is extremely rare in the DACH. Only a few centres perform REBOA more than once per year. A striking proportion of patients treated with REBOA had no hypotension, received no blood or massive transfusions, and underwent no emergency surgery, which may indicate that some patients were not in severe haemorrhage when REBOA was applied. On average, the REBOA-treated cohort was severely injured and critically ill. Whether REBOA use was beneficial and/or necessary in these patients cannot be determined from the present study.

PubMed:41275115 | DOI:10.1186/s12873-025-01417-3