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World J Crit Care Med. Sep 9, 2026; 15(3): 123705
Published online Sep 9, 2026. doi: 10.5492/wjccm.123705
Published online Sep 9, 2026. doi: 10.5492/wjccm.123705
Resuscitative endovascular balloon occlusion of the aorta in combat and austere environments
Marcelo Augusto Fontenelle Ribeiro Junior, Rafael Dib Possiedi, Department of Surgery, R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD 21201, United States
Marcelo Augusto Fontenelle Ribeiro Junior, Department of Surgery, Pontifical Catholic Uni
Rafael Dib Possiedi, Department of Surgery, Médecins Sans Frontières, Brussels 1050, Belgium
Rafael Dib Possiedi, Department of Surgery, UK-Med, Manchester M3 3WD, United Kingdom
Karine Matos de Albuquerque, School of Medicine, University of Porto, Porto 4200-319, Portugal
Leticia Stefani Pacheco, Health Sciences and Medical School of Sorocaba, Pontifical Catholic University of São Paulo - Campus Sorocaba, Sorocaba 18030070, Brazil
Luiza Telles, Discipline of Plastic Surgery, School of Medicine, University of São Paulo, São Paulo 01246-903, Brazil
Sariya Khan, General Medicine Practice Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia
Anaida Xacur-Trabulce, Department of General Surgery, Angeles Lomas Hospital, National Autonomous University of Mexico, Huixquilucan 52763, Mexico
Nicolas de Cesaro Schpchacki, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre 90619-900, Rio Grande do Sul, Brazil
Co-first authors: Marcelo Augusto Fontenelle Ribeiro Junior and Rafael Dib Possiedi.
Author contributions: Ribeiro Junior MAF and Dib Possiedi R contributed to concepts, literature research, manuscript editing, design and definition of intellectual content, they served as guarantors of the work and are co-first authors who contributed equally to this study; Matos de Albuquerque K and Telles L contributed to the data acquisition; Dib Possiedi R and Stefani Pacheco L contributed to the data analysis; Stefani Pacheco L and de Cesaro Schpchacki N contributed to the writing of the manuscript; Ribeiro Junior MAF, Dib Possiedi R, Xacur-Trabulce A, Khan S, Matos de Albuquerque K, Telles L, Stefani Pacheco L, and de Cesaro Schpchacki N contributed to manuscript preparation and manuscript review. All authors approved final revision of the paper.
AI contribution statement: AI tools were used to assist with deduplication and citation management (Zotero), study screening (Rayyan), and language editing (ChatGPT), during manuscript preparation. The authors reviewed and approved all AI generated content and are fully responsible for its accuracy and integrity.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Marcelo Augusto Fontenelle Ribeiro Junior, MD, PhD, ACC (Hon), CBC (Hon), FACS, FISS, MAMSE, Professor, Department of Surgery, R Adams Cowley Shock Trauma Center, University of Maryland, Room P1Go4G. 22 South Greene Street, Baltimore, MD 21201, United States. mfribeiro@som.umaryland.edu
Received: May 27, 2026
Revised: July 18, 2026
Accepted: July 28, 2026
Published online: September 9, 2026
Processing time: 87 Days and 14.5 Hours
Revised: July 18, 2026
Accepted: July 28, 2026
Published online: September 9, 2026
Processing time: 87 Days and 14.5 Hours
Core Tip
Core Tip: In austere and combat environments, non-compressible torso hemorrhage presents a critical challenge due to prolonged evacuation times and limited resources. Resuscitative endovascular balloon occlusion of the aorta has been increasingly described in these settings as an adjunctive intervention. This scoping review maps the current evidence on its use across diverse operational contexts, including prehospital and military care. However, available data are limited, heterogeneous, uncontrolled, and predominantly observational, highlighting variability in practice and important knowledge gaps that warrant further structured investigation.