Partners: TOKAI (Rescue Balloon, main partner for the workshop), BBraun, Cook Medical, Mentice, 3dimprimo, STILLE, Ziehm , Mentice, TBA
The main aim of this WS is to get a discussion and practice platform of endovascular hybrid Trauma & bleeding management (EVTM) using a multidisciplinary approach. Main issue is the vascular access, obtained by different methods (blind, Doppler, ultrasound, fluoroscopy and surgical access), usage in bleeding patients for temporary and permanent bleeding control. The usage of Aorta Balloon Occlusion (ABO/REBOA), as well as basic stents and embolization methods will be practiced. Bailout and alternative methods will be discussed and practiced. Basic postoperative considerations as intra-abdominal pressure monitoring will be practiced. Participant’s cases as well as ABOTrauma Registry cases will be discussed. The WS includes basic material knowledge, dry models as well as intensive training on live tissue. The WS give the basics for building a “REBOA or EVTM service” by the participants needs. The workshop is built for experienced physicians and adjusted to individual level during the practical moments. Participants will get all basic training and knowledge for REBOA placement as part of the EVTM concept.
Day 1 (1st February):Clinical Training Center (KTC), USÖ
Practical scenario on a training model with REBOA and more (45 min).
Aorta 3D models. Ultrasound station. C-arm usage, Angiography table, Mentice simulator trauma station. Practice and discussion with faculty in groups. Material for endo-trauma and hybrid management. The “ABO/ERBOA trolley”. Over the wire method (Seldinger) on dry model; Blind and ultrasound guided. Introducers and upgrading, REBOA, iREBOA and pREBOA. Basic ultrasound management for access is available.
Around 19:00 Departure to dinner - TBA
Day 2 (2 February): Animal lab training & research center, USÖ
07:15-08:30 Cadaver “EVTM anatomical review- what can we do?” including REBOA practical practice (Preliminary-if available case, to be announced the day before).
08:40-09:00 Breakfast with the industry (training center)
09:00-13:00Animal lab: Hands-on animal lab including vascular and endovascular access. ABO principles and practice. Basic angiography training and embolization. Basic ultrasound guided access. Hybrid procedures. Lunch and coffee will be served in the lab. Every station with highly experienced faculty and one-on-one training as well as group scenario discussions on live tissue.
Practical training points in the animal lab:
1) Material usage in bleeding patients, general considerations. The trauma-bay kit.
2) VascularAccess basic principles. Dissection techniques for access, Endoshunts (and shunts), hybrid procedures and other techniques. Puncture; Seldinger technique, ultrasound, blind, fluoroscopy, cut down.
3) Upgrading/introducers/guide wires. The failing access/alternatives including retroperitoneal, conduit, axillar etc. Access on venous side.
4) REBOA: Material and REBOA kit, practical deployment and using the ABO. Deflation and re-position issues; Intermitted/Partial inflation with MAP as target - pREBOA). Ongoing bleeding practice!
- Case discussions #2 during training.
5) Balloons in other locations (Iliac, Subclavian, and Brachiocephalic trunk/zone I neck), Sizing and techniques.