Outcomes and Evidence
Applied
Type
ModificationConfidence
85%
Created
Mar 26, 2026
Evidence
1 source
Rationale
The integration of the Cralley 2026-b (PMID 36542395) article provides critical nuance to the comparison between REBOA and resuscitative thoracotomy. The original text noted that results were 'mixed' and 'selection-dependent'; the new evidence specifies that the presence or absence of CPR is a key selection factor determining which intervention may be superior. Abbreviations (RT, CPR) were expanded on first use as per instructions.
Evidence
Content Changes
removedadded
<!-- type: evidence --> **Evidence landscape** Most endovascular trauma management (EVTM) outcome data are **observational** (registries, administrative datasets, and single-center series). Interpretation requires attention to indication, timing, comparator selection, and survivorship bias. [@trauma2016-aorta] [@matsumura2020] **resuscitative endovascular balloon occlusion of the aorta (REBOA) outcomes** - Registries demonstrate feasibility and define complication patterns; outcome signals vary by indication and practice environment. [@trauma2016-aorta] - Comparative observational analyses versus resuscitative thoracotomy (RT) show mixed results and are highly selection-dependent. [@brenner2018-survival] Recent registry data indicate that Zone 1 REBOA is associated with improved survival compared to RT in patients who do not require cardiopulmonary resuscitation (CPR), whereas RT may be superior for patients already in cardiac arrest. [@cralley2026-b] **Hybrid/endovascular strategy outcomes (what “success” means)** Beyond survival, meaningful endpoints include: - Time to hemorrhage control - Blood product utilization - Organ failure and ischemic complications (renal/visceral/limb) - Need for fasciotomy or access repair - Limb salvage and functional outcome (especially in extremity/junctional trauma). [@rasmussen2011-vascular] **Why registries remain central** Given case heterogeneity and low event frequency at single centers, multi-institution registries are important for benchmarking, governance, and complication surveillance. [@mani2020] See also: [[Vascular Trauma|Ch. 15]] for extremity injury outcomes and shunt/bypass benchmarks.