{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:27:31Z","timestamp":1786120051940,"version":"build-2736575974"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Air Force Medical Command\u2019s Operational Medicine Test and Evaluation Division"},{"name":"UC Davis Department of Surgery Civilian Military Partnership"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is a minimally invasive method to control noncompressible torso hemorrhage, now integral to military damage control resuscitation. Modern combat conditions may create mixed inventories of REBOA catheters that differ in balloon compliance, flow modulation, and monitoring capability. Understanding device-specific performance is essential for safe use and informed procurement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We conducted a head-to-head evaluation of 3 FDA-cleared, combat-deployable REBOA catheters: ER REBOA PLUS, pREBOA PRO, and COBRA OS. Testing used a custom pulsatile flow loop that simulated physiologic pressures, flows, and vessel dynamics. Devices were assessed for their ability to achieve complete Zone 1 occlusion, provide accurate pressure readings, correlate distal pulsatility and mean arterial pressure with true flow, and maintain controlled partial occlusion during simulated vasomotor and heart rate changes. Each system\u2019s logistical footprint, including mass and cube, was measured in field and packaged configurations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ER REBOA PLUS and pREBOA PRO achieved complete Zone 1 occlusion across aortic diameters up to 26 mm, while COBRA OS did not occlude above 22 mm. Only pREBOA PRO maintained stable partial flow with minimal drift during simulated vasoconstriction, vasodilation, and heart rate variation. The compliant balloons of ER REBOA PLUS and COBRA OS transmitted distal pulsatility despite negligible flow, indicating that pressure or waveform alone may misrepresent perfusion. pREBOA PRO demonstrated the most controllable flow response and strongest correlation between distal pressure and true flow. COBRA OS offered the lowest mass and volume but lacked integrated pressure monitoring and reliable partial REBOA function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>pREBOA PRO provided the most controllable partial occlusion and stable pressure flow relationship, supporting its use when prolonged occlusion or partial REBOA is anticipated. ER REBOA PLUS and COBRA OS remain suitable for short-duration complete occlusion but not for pressure-guided partial REBOA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usag028","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:54:50Z","timestamp":1769086490000},"page":"111-119","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating Partial Resuscitative Endovascular Balloon Occlusion of\u00a0the Aorta (REBOA) for Battlefield Trauma: A Comparative Analysis of Commercially Available Catheters"],"prefix":"10.1093","volume":"191","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3928-2849","authenticated-orcid":false,"given":"Shaddy","family":"Malik","sequence":"first","affiliation":[{"name":"Department of Surgery, University of California Davis Medical Center , Sacramento, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5927-4071","authenticated-orcid":false,"given":"Elise E","family":"Fannon","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California Davis Medical Center , Sacramento, CA,","place":["United States"]},{"name":"Clinical Investigation Facility, United States Air Force, Travis Air Force Base , Fairfield, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0216-6465","authenticated-orcid":false,"given":"Christian","family":"Gage","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California Davis Medical Center , Sacramento, CA,","place":["United States"]},{"name":"528th Sustainment Brigade, USASOC, United States Army, Medical Corps , Houston, TX,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5971-5508","authenticated-orcid":false,"given":"Rachel M","family":"Russo","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California Davis Medical Center , Sacramento, CA,","place":["United States"]},{"name":"Department of Surgery, Uniformed Services University of the Health Sciences , Bethesda, MD,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"2026080616022979300_usag028-B1","doi-asserted-by":"publisher","first-page":"S431","DOI":"10.1097\/TA.0b013e3182755dcc","article-title":"Death on the battlefield (2001-2011): implications for the future of combat casualty care","volume":"73","author":"Eastridge","year":"2012","journal-title":"J Trauma Acute Care Surg"},{"key":"2026080616022979300_usag028-B2","doi-asserted-by":"publisher","first-page":"S164","DOI":"10.1097\/TA.0000000000004683","article-title":"Scoping review and recommendation to establish standardized best practices for resuscitative endovascular balloon occlusion of the aorta in combat casualties: a North Atlantic treaty organization exploratory team report","volume":"99","author":"Russo","year":"2025","journal-title":"J Trauma Acute Care Surg"},{"key":"2026080616022979300_usag028-B3","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1093\/milmed\/usae095","article-title":"A PROMPT update on partial REBOA: initial clinical data and overview of the DoD-Funded partial REBOA outcomes multicenter ProspecTive (PROMPT) study","volume":"189","author":"Gondek","year":"2024","journal-title":"Mil Med"},{"key":"2026080616022979300_usag028-B4","doi-asserted-by":"publisher","first-page":"S180","DOI":"10.1097\/TA.0000000000004063-S4","article-title":"Casualty care implications of large-scale combat operations","volume":"95","author":"Remondelli","year":"2023","journal-title":"J Trauma Acute Care Surg"},{"key":"2026080616022979300_usag028-B5","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1093\/milmed\/usae152","article-title":"Advancing military medical planning in large scale combat operations: insights from computer simulation and experimentation in NATO\u2019s vigorous warrior exercise 2024","volume":"189","author":"Benhassine","year":"2024","journal-title":"Mil Med"},{"key":"2026080616022979300_usag028-B6","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.jss.2020.12.054","article-title":"Partial resuscitative endovascular balloon occlusion of the aorta: a systematic review of the preclinical and clinical literature","volume":"262","author":"Russo","year":"2021","journal-title":"J Surg Res"},{"key":"2026080616022979300_usag028-B7","doi-asserted-by":"publisher","first-page":"S56","DOI":"10.1097\/TA.0000000000003166","article-title":"Resuscitative endovascular balloon occlusion of the aorta in combat casualties: the past, present, and future","volume":"91","author":"Stokes","year":"2021","journal-title":"J Trauma Acute Care Surg"},{"key":"2026080616022979300_usag028-B8","doi-asserted-by":"publisher","first-page":"37","DOI":"10.55460\/YJB8-ZC0Y","article-title":"Advanced resuscitative care in tactical combat casualty care: TCCC guidelines change 18-01:14 october 2018","volume":"18","author":"Butler","year":"2018","journal-title":"J Spec Oper Med"},{"key":"2026080616022979300_usag028-B9","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1097\/TA.0000000000003042","article-title":"A novel partial resuscitative endovascular balloon aortic occlusion device that can be deployed in zone 1 for more than 2 hours with minimal provider 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occlusion of the aorta in a highly lethal swine liver injury model","volume":"80","author":"Russo","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"key":"2026080616022979300_usag028-B13","doi-asserted-by":"publisher","first-page":"S45","DOI":"10.1097\/TA.0000000000002770","article-title":"A new, pressure-regulated balloon catheter for partial resuscitative endovascular balloon occlusion of the aorta","volume":"89","author":"Russo","year":"2020","journal-title":"J Trauma Acute Care Surg"},{"key":"2026080616022979300_usag028-B14","doi-asserted-by":"publisher","first-page":"S94","DOI":"10.1097\/TA.0000000000003667","article-title":"The physiology of aortic flow and pressures during partial resuscitative endovascular balloon occlusion of the aorta in a swine model of hemorrhagic shock","volume":"93","author":"Marble","year":"2022","journal-title":"J Trauma Acute Care Surg"}],"container-title":["Military 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