Caicedo-Moncada, Brainerd Lenin; Beltrán-Torres, Felipe Andrés; Mendez-Ordoñez, Erika Marcela

ABSTRACT

Introduction: the use of endovascular occlusion balloon in elective non-cardiac surgery has emerged as an effective strategy to prevent intraoperative bleeding, a significant complication that can impact both surgical outcomes and patient recovery. This device, which selectively occludes large blood vessels, allows for precise control of blood flow, thereby minimizing the risk of hemorrhage and improving visibility in critical surgical areas. Material and methods: a search was performed across three major databases (PubMed, Ovid, and Embase), in addition to Google Scholar as a source of gray literature and the National Institute of Health (NIH) as a national database, covering the period from 2014 to 2024. Results: this systematic review included 17 articles; two showed a moderate risk of bias, while the others demonstrated good quality and low risk of bias. A total of 3,379 patients were analyzed, 95.3% women. The primary indication for the use of endovascular occlusion balloons was surgical procedures related to abnormal placentation in 67.5% of cases, with an average blood loss of 1,256 mL (SD: 699.9). The application of the balloon resulted in a significant reduction in blood loss of 856 mL (OR −3.43; 95% CI −6.22 to −0.63), with no significant differences observed in age, gender, or surgical duration. Conclusion: the use of intravascular balloon occlusion in elective non-cardiac general surgical procedures with a high risk of hemorrhage demonstrates effectiveness in reducing intraoperative blood loss. The most frequently observed complications include transient arterial thrombosis and localized issues at the puncture site. While various clinical scenarios for its application have been described, the strongest evidence supports its use in obstetric procedures, particularly those related to abnormal placentation.

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