REBOA Deployment Details: Zones, Occlusion Times, and Techniques

in Endovascular Trauma Management

Applied

Type

Reinforcement

Confidence

72%

Created

Mar 28, 2026

Evidence

1 source

Rationale

The Dewey 2025 registry study directly reinforces the existing recommendation for partial REBOA over complete occlusion by providing outcome data from the AORTA registry showing lower mortality with partial Zone I REBOA. No new content needs to be added; the citation is appended to the existing partial REBOA sentence to strengthen the evidence base for that recommendation. The citation density is kept consistent with the original section.

Evidence

Dewey MG. Partial REBOA Zone 1 is associated with lower mortality compared to complete REBOA Zone 1 and emergency department thoracotomy: A cohort study using the AORTA registry. Transfusion. 2025. PMID: 40059692. DOI: 10.1111/trf.18177.
Verified source
PubMedDOI

Content Changes

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Current guidelines emphasize that Zone II (celiac to lowest renal artery) should be avoided for balloon inflation [@bulger2019]. Zone I occlusion should be limited to the shortest possible duration, often suggested to be 30 minutes or less [@bulger2019], while Zone III occlusion is preferably limited to 60 minutes or less. Intermittent or partial resuscitative endovascular balloon occlusion of the aorta (REBOA) should be considered to reduce ischemic burden [@sadeghi2018-partial].[@sadeghi2018-partial; @dewey2025-partial].
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