Transfemoral Temporary Aortic Balloon Occlusion Assisting Open Repair for Ruptured Abdominal Aortic Aneurysms
Chumpol Wongwanit MD*, Pramook Mutirangura MD*, Khamin Chinsakchai MD*, Chanean Ruangsetakit MD, MSc*, Nuttawut Sermsathanasawadi MD, PhD*, Kiattisak Hongku MD*, Suteekhanit Hahtapornsawan MD*
Affiliation : * Division of Vascular Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
The mortality rate of ruptured abdominal aortic aneurysm (rAAA) is still high despite an advance in surgical
technology and critical care. The authors report three patients who had successful open repairs of rAAA assisted by
transfemoral temporary aortic balloon occlusion. Before the operation, these patients had severe abdominal pain with
hypotension. An aortic balloon occlusion catheter was introduced into the abdominal aorta under fluoroscopy at pararenal
level, which was accessed from the right common femoral artery under local anesthesia. After balloon inflation, a rapid
increase in arterial blood pressure was found and general anesthetic induction was started. Finally, open repair of rAAA
was successfully carried out with rapid proximal neck control by aortic balloon palpation. All the patients made an uneventful
recovery during the postoperative period and were discharged on day 16, day 8, and day 17 respectively.
Conclusion : Transfemoral temporary aortic balloon occlusion is an effective strategy in rapid proximal aortic control before
a conventional open repair of rAAA. It provides immediate hemostasis resulting in stabilized blood pressure before and
during anesthetic induction, and facilitated aortic neck identification.
Keywords : Temporary aortic balloon occlusion, Ruptured abdominal aortic aneurysm, Open abdominal aortic aneurysm repair
