Place the Sheath: Emergent 7 French Femoral Sheath Placement is Low Risk During Initial Trauma Resuscitation


  • Alexis L Cralley University of Colorado
  • Margot DeBot
  • Jamie Hadley
  • Fredric Pieracci
  • Barry K Platnick
  • Eric Campioin
  • Ernest E Moore
  • Mitchell J Cohen
  • Charles J Fox
  • Ryan A Lawless



Trauma Resuscitation, Emergent Common Femoral Artery Access, Resuscitative Endovascular Balloon Occlusion of the Aorta, Endovascular Resuscitation Complications


Background: We hypothesized that emergent placement of 7 French (Fr) common femoral artery (CFA) sheaths during trauma resuscitation for potential resuscitative endovascular balloon occlusion of the aorta (REBOA) carries a low complication rate.
Methods: Trauma patients at a Level I trauma center with emergent CFA access from January 2016 through to December 2020 were reviewed. CFA access was categorized as (1) 7 Fr sheath plus REBOA (REBOA) and (2) 7 Fr sheath without REBOA (Sheath). Outcomes included mortality and vascular complications.
Results: 157 patients underwent emergent CFA access. Sixty-nine (43.9%) patients had a 7 Fr CFA sheath, and 88 (56.1%) progressed to REBOA. The mortality rate was similar (Sheath 30.4% vs. REBOA 34.1%, p = 0.63). The REBOA cohort had a significantly higher complication rate (22.7%) compared to the Sheath cohort (4.3%, p = 0.001).
Conclusions: Emergent 7 Fr CFA sheath placement during trauma resuscitation is low risk, suggesting empiric sheath placement is warranted in potential REBOA candidates.



2023-01-20 — Updated on 2023-02-23


How to Cite

Cralley, A. L., DeBot, M., Hadley, J., Pieracci, F., Platnick, B. K., Campioin, E., Moore, E. E., Cohen, M. J., Fox, C. J., & Lawless, R. A. (2023). Place the Sheath: Emergent 7 French Femoral Sheath Placement is Low Risk During Initial Trauma Resuscitation. Journal of Endovascular Resuscitation and Trauma Management, 6(3). (Original work published January 20, 2023)



Original Article