Major Arterial Vascular Injury of the Extremities Treated by Temporary Intravascular Shunt

Abstract

Early revascularization of traumatic extremity vascular injuries is the most important factor for functional limb salvage. Use of a temporary intravascular shunt (TIVS) is one method for shortening the ischemic time. We present five cases in which a TIVS for traumatic major arterial vascular injury of the extremities was used. The average temporary revascularization time was 257 minutes after injury. The average definitive vascular repair time was 383 minutes after injury. The TIVS was inserted in an average of 22 minutes including approach to injured vessels. Thus, use of the TIVS shortened the revascularization time by 104 minutes on average. The average blood loss during the operation was 314 ml (90-950 ml). No patients developed ischemia-reperfusion injury. Fasciotomy was performed for two patients. All limbs were not infected and were able to be salvaged. Although use of a TIVS may increase the risk for bleeding, it plays an important role in shortening the ischemic time, and may be a standard treatment method for traumatic extremity vascular injuries.