New life-saving technique first in Western Canada

By Carrie Stefanson

Vancouver General Hospital (VGH) is the first hospital in Western Canada to use a new device to help save the lives of patients at risk of dying from a traumatic injury, such as a fractured pelvis or gunshot wound.

Resuscitative endovascular balloon occlusion of the aorta or REBOA is a technique where trauma and emergency teams place a balloon in the patient’s main artery from the heart to stop fatal bleeding. “REBOA extends what we’re able to do for our patients in that golden hour when they arrive at our hospital and are hemorrhaging,” says Dr. Naisan Garraway, Medical Director, Trauma Services, Vancouver Coastal Health.

A temporary balloon is placed in the patient’s aorta, via the large artery in the thigh (femoral artery). Once inflated, the balloon blocks blood flow to the wound, while still allowing blood to reach the brain and heart. This prevents patients from “bleeding out,” or dying of internal bleeding. With the balloon in, the clock is ticking. Emergency and trauma staff have about 45 minutes to provide life-saving measures to stabilize the patient for surgery.

The balloon used in the REBOA technique.

REBOA was first used on a patient in critical condition with multiple gunshot wounds to the abdomen. Less than 30 minutes after arriving at VGH, surgical and trauma teams led by Doctor Emilie Joos, performed REBOA. “For me, the decision was simple: either I would inflate this balloon in the patient’s aorta or he would die on the operating table,” say Dr. Joos. “The REBOA allowed me to find and control bleeding from multiple injuries, without worrying about blood loss.”

Major trauma is one of the leading causes of death for people under age 45 in Canada. More than 700,000 people are injured yearly in BC. Of these, approximately 1,800 die, 9,000 suffer permanent disability, and 27,000 are hospitalized.  VGH is one of two Level 1 adult trauma centres in BC, providing the most advanced trauma services.

“Implementing REBOA at VGH helps us to continue to be on the leading edge of trauma care,” says Dr. Garraway. “This new tool and the expertise of our emergency and trauma staff can only benefit the most critically injured patients in our province.”

REBOA has its origins in the battlefield. It’s an advanced version of a catheter first used by military trauma surgeons to stop bleeding from gunshot wounds. It was introduced in the U.S. in 2016, followed by Europe and Canada.

Vancouver Coastal Health is responsible for the delivery of $3.3 billion in community, hospital and residential care to more than one million people in communities including Richmond, Vancouver, the North Shore, Sunshine Coast, Sea to Sky corridor, Powell River, Bella Bella and Bella Coola. VCH also provides highly specialized care and services for people throughout BC, and is the province’s hub of health care education and research.

Carrie Stefanson is the Public Affairs Leader, Vancouver Coastal Health.