Femoral arterial closure after REBOA using the Fascia Suture Technique: first experiences in a military setting

Abstract

Femoral vascular closure after REBOA can be challenging, and lead to complications due to the large-caliber sheath used and acute traumatic coagulopathy. The Fascia Suture Technique (FST) has been proposed as a safe, easy-to-use and cheap method for reliable vascular closure. We present two cases of critically unstable patients for whom this technique was successfully used after REBOA placement through 8 Fr and 10 Fr sheaths at a Role 2 medical treatment facility. In one case, the FST was used for closure of both the femoral artery and vein, and femoral vascular closure took 6-7 minutes for each procedure (in both cases). No additional sutures were needed before reliable hemostasis was achieved. No hematoma or any other complication was noted during air transportation and, afterwards, until discharge. This report clearly demonstrates the possibility of using the Fascia Suture Technique, and its effectiveness in austere environments.