Technical Considerations for the Use of REBOA in the Management of Placenta Accreta Spectrum

Introduction: In recent years, the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) has become popular to prevent or treat massive bleeding due to placenta accreta spectrum (PAS). Objective: There are multiple variations in REBOA use in this context and although the experience of vascular surgeons is extensive with aortic balloons, there are particularities in the management of these devices in the obstetric population that deserve to be discussed. Methods: We discuss some technical considerations or “lessons learned” in our center that may be useful for other groups starting to use REBOA in PAS Conclusion: Although REBOA is a useful strategy to prevent or treat massive bleeding due to PAS, its incorporation into management protocols must be carried out in a programmed and supervised manner.