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Cardiac Arrest (CA)ATTICANCT07573566

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

A study testing Abdominal Aortic Junction Tourniquet in non-traumatic out-of-hospital cardiac arrest in people with Cardiac Arrest (CA) and Out-of-hospital Cardiac Arrest (OHCA), run by Klinikum Klagenfurt am Wörthersee at 1 site in Austria.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial 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. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Abdominal Aortic Junction Tourniquet in non-traumatic out-of-hospital cardiac arrest
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
5 participants
Where
1 siteAustria
Study dates
Aug 2026to Sep 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

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

Who cannot join

  • Pregnancy (suspected or confirmed)
  • Age < 18 years
  • Abdominal circumference does not allow application of the AAJT
  • Traumatic etiology
  • Planned eCPR or other intervention in which study inclusion would delay the standard of care
  • Known abdominal aortic aneurysm

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Simon Sommerhuber, MD contact

004346353826109

simon.sommerhuber@kabeg.at

Austria1 site
  • Klinikum Klagenfurt am Wörthersee

    Klagenfurt, Carinthia, 9020

    Simon Sommerhuber, MD, 004346353826109, simon.sommerhuber@kabeg.at

Other trials in Austria

About this study

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.

Read the detailed description

Background There is now a substantial body of experimental and clinical research on resuscitative endovascular balloon occlusion of the aorta (REBOA), highlighting its potential role in resuscitation medicine. As early as 1993, a porcine model was used for the first time to investigate the effect of REBOA on the quality of cardiopulmonary resuscitation. In this study on anesthetized pigs, temporary occlusion of the aorta during cardiopulmonary Resuscitation (CPR) resulted in a significant improvement in central hemodynamic parameters, particularly an increase in coronary perfusion pressure.

Initial case series from the past 10 years have also examined the use of REBOA in non-traumatic cardiac arrest. Despite overall small sample sizes, they demonstrated significant increases in end-tidal CO₂ (etCO₂) as well as higher rates of any ROSC. A common feature of both studies was the relatively long interval from emergency call to REBOA application, exceeding 45 minutes in each.

More recent studies from the past five years have confirmed these conclusions: REBOA placement led to improvements in various resuscitation indices. However, the procedure is often technically challenging, and when performed in-hospital, it typically took place more than 45 minutes after the initial emergency call. Two of the centers involved in these studies have now started to recruit for randomized controlled trials with more than 200 patients.

As an alternative to REBOA placement in Zone 3 for hemodynamically unstable patients in hemorrhagic shock due to pelvic or lower extremity injuries, the Abdominal Aortic Junctional Tourniquet (AAJT) is available. The first publication appeared in 2009, and market approval in the United States was granted in 2013. The device applies external pressure on the abdomen via balloon inflation under a abdominal binder with the goal of occluding flow in the abdominal aorta.

For non-traumatic cardiac arrest, there is currently only one animal study involving six pigs. In this study, AAJT application improved blood flow and diastolic pressure in the carotid artery, but did not confer a survival benefit.

During resuscitation, a diastolic blood pressure of over 30 mmHg should be achieved. This was reaffirmed in the latest European Resuscitation Council (ERC) guidelines of 2025, as it is associated with an increased rate of survival to hospital discharge.

Case series describing the application of the AAJT in traumatic cardiac arrest have demonstrated a notably high rate of favorable physiological responses. Reported positive outcomes include a change from non-perfusing or disorganized rhythms to more organized cardiac rhythms, an increase in end-tidal carbon dioxide (etCO₂) as a surrogate marker of improved circulation and perfusion, and, in several cases, the achievement of return of spontaneous circulation (ROSC). These findings suggest that temporary aortic occlusion using the AAJT may improve central blood flow and augment coronary as well as cerebral perfusion during resuscitation efforts.

Rationale The aortic occlusion during medical cardiac arrest with REBOA has shown promising results, but time-to-occlusion often requires a significant amount of time, with a high failure rate. The aortic occlusion with the AAJT device is a faster and non-invasive approach to the same problem. This study aims to show the feasibility of this rationale in a limited amount of patients.

Being tested
Abdominal Aortic Junction Tourniquet in non-traumatic out-of-hospital cardiac arrest
Keywords
AAJT, OHCA, Aortic occlusion
Medical subject headings
Heart Arrest, Out-of-Hospital Cardiac Arrest, Ventricular Fibrillation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Abdominal Aortic Junction Tourniquet in non-traumatic out-of-hospital cardiac arrestDevice

    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
Study groups in NCT07573566
Study groupRoleWhat they receive
Abdominal aortic occlusion by AAJT ApplicationExperimentalNot described
Receives: Device: Abdominal Aortic Junction Tourniquet in non-traumatic out-of-hospital cardiac arrest

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Time from initiation of AAJT application to complete inflation

    Measured: 1 hour

Secondary outcomes (7)
  1. Time from dispatch to application

    Measured: 1 hour

  2. time from arrival on scene to application

    Measured: 1 hour

  3. time from initiation of resuscitation to application

    Measured: 1 hour

  4. change in end-tidal CO₂ (etCO₂) measured in mmHg

    Measured: 1 hour

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

    Measured: 1 hour

  6. any ROSC rate

    Measured: 24 hours

  7. sustained ROSC rate

    Measured: 24 hours

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 May 2026
  2. Study startAug 2026 (estimated)
  3. Primary completionJul 2027 (estimated)
  4. Study completionSep 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
5 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07573566
Sponsor's protocol ID
S2026-04
Acronym
ATTICA
Status last verified
Apr 2026
First submitted
23 Apr 2026
Last updated
7 May 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Due to the low number of included patients there are concerns regarding privacy.

Publications

  • 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.

    PubMed 38347550
  • 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.

    PubMed 34332617
  • 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.

    PubMed 40679120
  • 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.

    PubMed 40063952
  • 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.

    PubMed 32979403
  • 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.

    PubMed 33046311
  • 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.

    PubMed 34848491
  • 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.

    PubMed 36176506
  • 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.

    PubMed 35870557
  • 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.

    PubMed 32866549

Questions about this trial

What is this clinical trial studying?

A study testing Abdominal Aortic Junction Tourniquet in non-traumatic out-of-hospital cardiac arrest in people with Cardiac Arrest (CA) and Out-of-hospital Cardiac Arrest (OHCA), run by Klinikum Klagenfurt am Wörthersee at 1 site in Austria.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 7 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Austria. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Simon Sommerhuber, MD (004346353826109, simon.sommerhuber@kabeg.at), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Time from initiation of AAJT application to complete inflation (time frame: 1 hour). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07573566, which also lists 10 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 May 2026.

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