Travmada Girişimler: REBOA
Özet
Kanama, travmatik yaralanmayı takiben önlenebilir ölümlerin önde gelen nedenidir. Aortun Resüsitatif Endovasküler Balon Oklüzyonu (REBOA), diyaframın altında meydana gelen sıkıştırılamayan gövde kanamalarını geçici olarak kontrol altına almak amacıyla kullanılan modern bir endovasküler tekniktir. Bu yöntem, kateter tabanlı bir balonun, ortak femoral arter yoluyla aortaya retrograd şekilde ilerletilmesi prensibine dayanır. Balon, aortu oklüde edecek şekilde şişirilerek kan akışını durdurur. Bu işlem, resüsitatif torakotomi sırasında aortun çapraz klemplenmesiyle elde edilen sonuca benzer bir hemostatik etki yaratmayı hedefler.
En sık kullanım endikasyonu travma olmakla birlikte obstetrik acil durumlar, spontan intraabdominal kanamalar, retroperitoneal sarkom rezeksiyonları gibi travma dışı uygulamalarda da kullanımı mevcuttur. Uygulama kararı, uygulamadaki zorluklar ve yakın takip gerekliliği yüksek miktarda tecrübe ve özveri istemektedir.
Kar – zarar dengesini iyi kurmanın yanı sıra teknik, mümkün olduğunca tecrübeli ekiplerce doğru endikasyonlara uygulanmalıdır. Bu bölümde REBOA hakkında güncel bilgiler ve yakın zamanda karşılaşmamızın olası olduğu olası gelişmelerden bahsedilecektir.
Referanslar
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