Selective Aortic Arch Perfusion Technologies for Hemorrhage-induced Cardiac Arrest

Trauma is the most common cause of death in ages 1-48. Uncontrolled hemorrhage in the torso is the leading cause of preventable death in military combatants and civilian trauma patients with otherwise survivable injuries. The prospects for survival from hemorrhage-induced traumatic cardiac arrest (HiTCA) are dismal with only about a 1% survival rate. Advances in endovascular technologies have led to the development of resuscitative endovascular balloon occlusion of the aorta (REBOA) but is not very effective once cardiac arrest has occurred. Selective Aortic Arch Perfusion (SAAP) is an endovascular-extracorporeal perfusion technique created specifically for resuscitation from cardiac arrest (both traumatic and medical/non-traumatic/medical). Dr. Manning has been developing SAAP in laboratory models of both HiTCA and ventricular fibrillation/medical cardiac arrest since 1989. SAAP involves the femoral artery insertion of a large-lumen balloon occlusion catheter that is advanced to the descending thoracic aortic arch. Inflation of the balloon isolates the aortic arch vessels, including the coronary arteries as well as carotid and vertebral arteries supplying the brain, for resuscitative perfusion during cardiac arrest to achieve return of spontaneous circulation (ROSC). In Phase I, we successfully developed a high-flow low-profile SAAP catheter and a coupling mechanism for use of SAAP with ECMO.