Abdominal Aortic Tourniquet Application for Non-Traumatic Out-of-Hospital Cardiac Arrest

NCT07573566 | Not Yet Recruiting

• 1 other identifier: S2026-04
• Study Type: interventional
• Target: 5
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of the study is to investigate whether occluding the abdominal aorta with an external device could be a potential therapeutic option in cases of non-traumatic cardiac arrest occurring outside of a hospital. In cardiac arrest, the heart suddenly stops beating, causing the circulation of blood to collapse. In this situation, vital organs-especially the brain and the heart itself-are no longer adequately supplied with oxygen. Without immediate treatment, severe damage or death occurs within minutes. The study therefore examines a specific intervention: the temporary occlusion of the abdominal aorta, which carries blood to the lower regions of the body. If this artery is blocked for a short period, the available blood can be redirected more effectively to the upper parts of the body. In theory, this could improve the oxygen supply to these organs and increase the likelihood that the heart will resume beating or that neurological damage can be reduced.

Conditions

Cardiac Arrest (CA); Out-of-hospital Cardiac Arrest (OHCA); Asystole; Pulseless Electrical Activity; Ventricular Fibrillation

Keywords

AAJT; OHCA; Aortic occlusion

Outcome Measures

Primary Outcomes (1)

• Time from initiation of AAJT application to complete inflation

  1 hour

Secondary Outcomes (7)

• Time from dispatch to application

  1 hour

• time from arrival on scene to application

  1 hour

• time from initiation of resuscitation to application

  1 hour

• change in end-tidal CO₂ (etCO₂) measured in mmHg

  1 hour

• measured change in arterial pressures (systolic/diastolic/mean arterial pressure)

  1 hour

Other Outcomes (2)

• In patients admitted to the hospital with ROSC who underwent CT of the thorax and abdomen: percentage of patients with intrathoracic injuries; percentage of patients with intra-abdominal injuries

  30 days

• In patients without ROSC in whom an autopsy was performed: percentage of patients with intrathoracic injuries; percentage of patients with intra-abdominal injuries

  30 days

Study Arms (1)

Abdominal aortic occlusion by AAJT Application

EXPERIMENTAL

Device: Abdominal Aortic Junction Tourniquet in non-traumatic out-of-hospital cardiac arrest

Interventions

Abdominal Aortic Junction Tourniquet in non-traumatic out-of-hospital cardiac arrest DEVICE

If a patient is found in cardiac arrest, eligibility is assessed. If the patient is deemed eligible, the following steps are performed: 1. Initiation of standard Advanced Cardiac Life Support (ACLS) 2. Endotracheal intubation and controlled mandatory ventilation according to ERC 2025 guidelines 3. Initiation of mechanical CPR 4. Arterial cannulation of an artery in the left upper extremity; access via the right upper extremity may be attempted after two unsuccessful attempts 5. Exclusion of reversible causes based on clinical history, physical examination, and/or ultrasound 6. Inflation of the AAJT 7. Device removal and termination of resuscitation (TOR) if ERC criteria are met 8. If return of spontaneous circulation (ROSC) is achieved, the AAJT remains in place until normotension is established, either spontaneously or with vasopressor support

Abdominal aortic occlusion by AAJT Application

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Cardiac arrest with indication for initiation of resuscitation
• Age ≥ 18 years

You may not qualify if:

• Pregnancy (suspected or confirmed)
• Age \< 18 years
• Abdominal circumference does not allow application of the AAJT
• Traumatic etiology
• Known abdominal aortic aneurysm

Sponsors & Collaborators

• Klinikum Klagenfurt am Wörthersee: lead

Study Sites (1)

Klinikum Klagenfurt am Wörthersee

Klagenfurt, Carinthia, 9020, Austria

Location

Related Publications (10)

• Kim HE, Chu SE, Jo YH, Chiang WC, Jang DH, Chang CH, Oh SH, Chen HA, Park SM, Sun JT, Lee DK. Effect of resuscitative endovascular balloon occlusion of the aorta in nontraumatic out-of-hospital cardiac arrest: a multinational, multicenter, randomized, controlled trial. Trials. 2024 Feb 13;25(1):118. doi: 10.1186/s13063-024-07928-x.

  PMID: 38347550 BACKGROUND

• Brede JR, Skulberg AK, Rehn M, Thorsen K, Klepstad P, Tylleskar I, Farbu B, Dale J, Nordseth T, Wiseth R, Kruger AJ. REBOARREST, resuscitative endovascular balloon occlusion of the aorta in non-traumatic out-of-hospital cardiac arrest: a study protocol for a randomised, parallel group, clinical multicentre trial. Trials. 2021 Jul 31;22(1):511. doi: 10.1186/s13063-021-05477-1.

  PMID: 34332617 BACKGROUND

• Poliakova Y, Oshovskyy V. Temporary aortic occlusion with the abdominal tourniquet for refractory postpartum hemorrhage: A proof-of-concept study in a war-affected region. Int J Gynaecol Obstet. 2026 Jan;172(1):582-587. doi: 10.1002/ijgo.70395. Epub 2025 Jul 18.

  PMID: 40679120 BACKGROUND

• Androshchuk D, Verba A. Successful Management of Battlefield Traumatic Cardiac Arrest Using the Abdominal Aortic and Junctional Tourniquet (AAJT): A Case Series. J Spec Oper Med. 2025 Apr 4;25(1):65-69. doi: 10.55460/7FEV-3ZRK.

  PMID: 40063952 BACKGROUND

• Balian F, Garner AA, Weatherall A, Lee A. First experience with the abdominal aortic and junctional tourniquet in prehospital traumatic cardiac arrest. Resuscitation. 2020 Nov;156:210-214. doi: 10.1016/j.resuscitation.2020.09.018. Epub 2020 Sep 23.

  PMID: 32979403 BACKGROUND

• Hewitt CW, Pombo MA, Blough PE, Castaneda MG, Percival TJ, Rall JM. Effect of the Abdominal Aortic and Junctional Tourniquet on chest compressions in a swine model of ventricular fibrillation. Am J Emerg Med. 2021 Jul;45:297-302. doi: 10.1016/j.ajem.2020.08.075. Epub 2020 Aug 27.

  PMID: 33046311 BACKGROUND

• Smith TN, Beaven A, Handford C, Sellon E, Parker PJ. Abdominal Aortic Junctional Tourniquet - Stabilized (AAJTS) can be applied both successfully and rapidly by Combat Medical Technicians (CMTs). BMJ Mil Health. 2023 Nov 22;169(6):493-498. doi: 10.1136/bmjmilitary-2021-001881.

  PMID: 34848491 BACKGROUND

• Daley J, Buckley R, Kisken KC, Barber D, Ayyagari R, Wira C, Aydin A, Latich I, Lozada JCP, Joseph D, Marino A, Mojibian H, Pollak J, Chaar CO, Bonz J, Belsky J, Coughlin R, Liu R, Sather J, Van Tonder R, Beekman R, Fults E, Johnson A, Moore C. Emergency department initiated resuscitative endovascular balloon occlusion of the aorta (REBOA) for out-of-hospital cardiac arrest is feasible and associated with improvements in end-tidal carbon dioxide. J Am Coll Emerg Physicians Open. 2022 Sep 10;3(5):e12791. doi: 10.1002/emp2.12791. eCollection 2022 Oct.

  PMID: 36176506 BACKGROUND

• Jang DH, Lee DK, Jo YH, Park SM, Oh YT, Im CW. Resuscitative endovascular occlusion of the aorta (REBOA) as a mechanical method for increasing the coronary perfusion pressure in non-traumatic out-of-hospital cardiac arrest patients. Resuscitation. 2022 Oct;179:277-284. doi: 10.1016/j.resuscitation.2022.07.020. Epub 2022 Jul 21.

  PMID: 35870557 BACKGROUND

• Levis A, Greif R, Hautz WE, Lehmann LE, Hunziker L, Fehr T, Haenggi M. Resuscitative endovascular balloon occlusion of the aorta (REBOA) during cardiopulmonary resuscitation: A pilot study. Resuscitation. 2020 Nov;156:27-34. doi: 10.1016/j.resuscitation.2020.08.118. Epub 2020 Aug 29.

  PMID: 32866549 BACKGROUND

MeSH Terms

Conditions

Heart Arrest; Out-of-Hospital Cardiac Arrest; Ventricular Fibrillation

Condition Hierarchy (Ancestors)

Heart Diseases; Cardiovascular Diseases; Arrhythmias, Cardiac; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Central Study Contacts

Simon Sommerhuber, MD

CONTACT

004346353826109; simon.sommerhuber@kabeg.at

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Attending

Study Record Dates

• First Submitted: April 23, 2026
• First Posted: May 7, 2026
• Study Start (Estimated): August 1, 2026
• Primary Completion (Estimated): July 1, 2027
• Study Completion (Estimated): September 1, 2027
• Last Updated: May 7, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

AU (1)