Fluoroscopy-independent, endovascular aortic occlusion system
A system for deploying and selectively inflating a thoracic aortic balloon at a desired location within the thoracic aorta for resuscitative aortic occlusion, inferior to the left subclavian artery, without the aid of fluoroscopy is described. Using CT imaging data, a distance between readily identifiable and consistently located external landmarks of torso extent is measured. Next, using the same data, a second distance from the femoral artery to a desired aortic occlusion location inferior to the left subclavian artery is determined. A correlation between the external measure of torso extent and the desired intra-arterial (i.e. endovascular) distance within the torso is made. Using a nomogram, a calibrated endovascular resuscitative thoracic aortic occlusion system can be positioned to this desired location on any injured individual with end-stage shock and impending cardiovascular collapse or death without the aid of fluoroscopy for delivery or balloon inflation.
1. A thoracic aortic occlusion system comprising:
an endovascular wire;
a balloon shaft comprising an aortic occlusion balloon on a distal end of the balloon shaft and a lumen to permit the balloon shaft to pass over the endovascular wire when the endovascular wire and the balloon shaft are inserted into a femoral artery at a femoral head of a patient; and
a nomogram comprising one of a table, chart or graph correlating distances between at least two external anatomical landmarks of each human of a pool of humans to centerline distances from the femoral artery at the femoral head to a location within a thoracic aorta of each of the humans, where a distance between at least two anatomical landmarks is measured on a patient and compared to the distances between the at least two external anatomical landmarks on the nomogram to calculate a length to which the endovascular wire and the balloon shaft are to be inserted in the patient such that the aortic occlusion balloon is positioned at a desired location within the thoracic aorta without using fluoroscopy.
2. The system of claim 1 , wherein the location within the thoracic aorta coincides with an aortic branch artery landmark.
3. The system of claim 1 , wherein the location within the thoracic aorta is inferior to the origin of the left subclavian artery.
4. A method for deploying and selectively inflating a thoracic aortic balloon at a desired location within a thoracic aorta of a patient, comprising:
measuring a distance between at least two readily externally identifiable anatomical landmarks of the patient, said anatomical landmarks including at least a symphysis pubis of the patient and a sternal notch of the patient;
comparing the distance between the at least two external anatomical landmarks of the patient to a prediction model and calculating a length to which a calibrated endovascular wire and a balloon shaft of the thoracic occlusion system are to be inserted in the patient, the prediction model having correlation data for distances between the at least two external anatomical landmarks of torso extent of a pool of humans to centerline distances from a femoral artery at a femoral head to a location within the thoracic aorta of humans, the data measured using CT imaging; and
inserting the calibrated endovascular wire and the balloon shaft to the length calculated for the patient independent of fluoroscopy.
5. The method of claim 4 , wherein the prediction model is one of a table, a chart, a graph, or a nomogram.
6. The method of claim 4 , wherein the method further includes pre-securing the balloon shaft to the endovascular wire proximate a trailing securement bead, allowing the balloon shaft and the endovascular wire to be inserted in the patient and delivered as a single unit.