Endovascular Aortic Balloon Occlusion in Obstetrics

Endovascular Aortic Balloon Occlusion in Obstetrics

Karin A. Fox

Laura J. Moore


Physical Examination

  • Identify appropriate external anatomical landmarks to access the femoral artery. The femoral artery is located in the femoral triangle, which is bordered superiorly by the inguinal ligament, medially by the adductor longus muscle, and laterally by the sartorius muscle.

  • Inguinal ligament (which runs from the anterior superior iliac spine to superolateral pubic tubercle): The common femoral artery (CFA) is 2 cm below the inguinal ligament (Figure 6.7.2).

  • In obese patients, consider cephalad retraction of the pannus by an assistant to facilitate the identification of external landmarks. It is important to identify the bony landmarks to properly locate the inguinal ligament, as the inguinal skin folds will not provide accurate localization of the CFA.

  • Some balloon catheters designed specifically for aortic occlusion have centimeter marks, and on average, placement of the catheter is around 28 cm for zone 3 placement (tip of the catheter to the xyphoid process or balloon placed at the level of the umbilicus).

  • Ultrasound guidance for identification and verification of access within the femoral artery is the standard of care. Caution should be used in arteries that have extensive plaque formation or calcifications.


  • Ultrasound guidance is the standard during access to the femoral artery.

  • Once the approximate location of the CFA is identified, ultrasound can be used to confirm the location and visualize needle-guided access and catheter placement.

  • Ultrasound may also be used post removal of the catheter and sheath to assess the integrity of the arterial wall or for signs of thrombus formation. A routine vascular ultrasound of the access site in the CFA is recommended 48 hours after sheath removal to evaluate for pseudoaneurysm formation.

  • Balloon placement may be confirmed by direct palpation of the balloon, using an x-ray or a portable C-arm and fluoroscopy.


Sep 9, 2022 | Posted by in OBSTETRICS | Comments Off on Endovascular Aortic Balloon Occlusion in Obstetrics

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