A Little Flow Goes a Long Way: A Systematic Review of Partial Versus Complete Resuscitative Endovascular Balloon Occlusion of the Aorta in the Hemorrhaging Trauma Patient

This systematic review examines recent clinical evidence comparing partial versus complete resuscitative endovascular balloon occlusion of the aorta (REBOA) in adult trauma patients with noncompressible torso hemorrhage. While REBOA is an important intervention for hemorrhagic shock, complete aortic occlusion is associated with complications such as distal ischemia and end-organ injury. Partial REBOA (pREBOA) has emerged as a strategy to preserve distal perfusion while maintaining hemodynamic support. This review analyzes studies published since 2021 to evaluate outcomes including mortality, acute kidney injury, and resuscitation requirements. Findings suggest that pREBOA may reduce mortality, decrease blood product utilization, and lower complication rates, though results are not consistent across all studies. Current evidence is limited to observational data and may be influenced by bias, emphasizing the need for independent randomized controlled trials to guide clinical practice.