BACKGROUND: Temporary arterial shunts maintain perfusion while surgeons pos
tpone arterial repairs; The common indications are combined orthopedic and
vascular injuries and damage control. The duration of patency and the need
for systemic anticoagulation remain in question. We examined our experience
for answers.
METHODS: We searched for patients who had temporary arterial shunts and col
lected the following: mechanism, artery injured, shunt time, blood loss and
transfusions, injury severity score (ISS,) mangled extremity severity scor
e (MESS,) and anticoagulation.
RESULTS: Of 19 patients, 10 had shunts for damage control (group 1,) and 9,
for orthopedic/vascular injuries (group 2.) group 1 had significantly high
er shunt time, mortality, ISS, and MESS. Shunt time ranged from 47 to 3,130
minutes (52 hours.) Two patients, 1 in each group, required amputations.
CONCLUSIONS: Temporary arterial shunts can be use for combined orthopedic a
nd vascular injuries and for damage control. Shunts can stay open for 52 ho
urs without systemic anticoagulation. (C) 2001 by Excerpta Medica, Inc.