# Foley catheter balloon tamponade for actively bleeding wounds following penetrating neck injury: a systematic review and meta-analysis

## TL;DR

This study reviews the use of Foley catheter balloon tamponade to control bleeding in neck injuries, finding it effective in some cases but needing more research for standardization.

## Contribution

The study provides a systematic review and meta-analysis of FCBT for bleeding neck injuries, highlighting its potential and limitations.

## Key findings

- FCBT achieved primary haemostasis in 62.50% to 100% of cases across studies.
- About 53.47% of patients underwent surgical exploration after FCBT.
- Pooled morbidity and mortality rates were 11.70% and 6.30%, respectively.

## Abstract

This study evaluated the efficacy and safety of Foley catheter balloon tamponade (FCBT) for actively bleeding penetrating neck injuries (PNI), focusing on rates of haemostatic success, subsequent surgical exploration, morbidity and mortality associated with FCBT in PNI.

A systematic search of Medline/PubMed, Embase, CINAHL and the Cochrane Library was conducted to 29 May 2025. Observational studies reporting FCBT outcomes in actively bleeding PNI were included. Pooled proportions were calculated with random effects models using Freeman–Tukey double-arcsine transformation; heterogeneity was explored with subgroup analysis and meta-regression. Study quality was assessed using the ROBINS-I tool.

Nine studies (1,658 participants) were included. FCBT was deployed in 236 cases, yielding a pooled rate of use of 27.85% (95% confidence interval [CI] 2.27 to 64.60, I2 = 97%, p < 0.01). Primary haemostasis was achieved in 62.50% to 100% across studies, with most series reporting success rates exceeding 80.00%. In total, 53.47% (95% CI 16.97 to 88.27, I2 = 61%, p = 0.0360) underwent surgical exploration, most often for major vascular injury or rebleeding at removal. Pooled morbidity and mortality were 11.70% (95% CI 0.00 to 50.47) and 6.30% (95% CI 0.00 to 19.97), respectively.

FCBT is a simple, rapid technique that achieves temporary haemorrhage control in PNI, providing a bridge to definitive surgical control, and may be effective as definitive treatment in selected venous injuries. However, pooled data are limited by heterogeneity in catheter size, balloon inflation and dwell time, restricting interpretability. Standardised multicentre prospective studies are needed to refine indications, optimise technique, and quantify complications.