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Nebraska Medical Center uses new catheter to stop fatal bleeding, possibly for 1st time in the state

January 26, 2018 GMT

Most people are familiar with the balloon-tipped catheters that doctors for years have been threading through people’s arteries to open clogs and improve blood flow.

In late December, a doctor at the Nebraska Medical Center used a similar device to instead block an artery and temporarily stop potentially fatal bleeding in a patient who had suffered a “penetrating trauma.”

Dr. Lisa Schlitzkus, the trauma surgeon who performed the procedure, said hospital officials believe that it was the first time the minimally invasive procedure, developed by military surgeons, has been used in the state. Schlitzkus and two others, fellow trauma surgeon Dr. Charity Evans and Dr. Jason MacTaggart, a vascular surgeon, spoke at a press conference Wednesday.

All of CHI Health’s trauma surgeons have been trained in the technique, but they have not had occasion to use it, a spokeswoman said.

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Bleeding, Schlitzkus said, is the No. 1 cause of death in trauma patients, both in the civilian and military realms. Traditionally, doctors have had to make a large incision in the chest in order to go in and stop serious internal bleeding. That creates a risk of complications.

“This can be done in the same time frame, accomplish the same goals, with fewer risks,” she said.

The new procedure involves inserting a catheter called the ER-REBOA into the femoral artery in the leg, threading it up into the chest and inflating it in order to block blood flow to the lower body.

PryTime Medical, a San Antonio, Texas, company, manufactures the device. A military prototype was approved by the U.S. Food and Drug Administration in 2016 and used on battlefields in Iraq and Afghanistan.

Schlitzkus stressed that the procedure isn’t a definitive treatment but a bridge to it. It can buy doctors time to gather more information or arrange specialized treatment.

But the doctors said they believe that the technique eventually could be used by doctors in regional emergency rooms who could stabilize patients and send them on for treatment and potentially even by emergency responders in both the civilian and military realms. In the United Kingdom, Schlitzkus said, doctors accompany emergency crews to place the catheter in the field.

It also could be used in other bleeding emergencies, such as ruptured abdominal aneurysms or post-partum hemorrhage. Research is underway to explore many such uses.

Schlitzkus said the team began working on bringing it to the medical center in 2015. Adopting it required putting systems in place and educating a variety of medical providers.

MacTaggart, the vascular surgeon, said not all trauma centers have adopted the technique. The doctors, and several others, have a Defense Department grant to work on training for medical providers of various skill levels. Researchers, working under a separate grant, also are conducting more basic research.

The medical center team took its time in selecting a patient who met its criteria. That patient not only survived but is doing well and is expected to begin rehabilitation soon.