TEMPORARY INTRA VASCULAR SHUNT FOR VASCULAR TRAUMA
Objective: To highlight the efficacy of temporary vascular shunts in saving life and limb.
Study Design: Case series.
Place and Duration of Study: Combined Military Hospital Rawalpindi, Lahore and Combined Military Hospital Quetta, from May 2006 to Jul 2014.
Methodology: The data of those patients who had temporary intra vascular shunts were analyzed for the demography, location of hospital for shunt placement, material used as shunt, time of vascular repair after shunt placement, shunt patency and limb survival.
Results: A total of 21 (All male, mean age 32 ± 17 years) patients of arterial trauma were included. 16 (76.1%) shunts were placed in peripheral hospitals for transportation while 5 (23.8%) were placed in tertiary care hospital, out of which 2 (9.5%) were for vascular damage control while 3 (14.2%) were for orthopedic surgery before definite vascular repair. Mean time to definite vascular intervention was 8 ± 6 hours. Prior to placing vascular shunt, distal embolectomy was done in 8 (38%) cases; while distal compression, back bleed and irrigation with heparinized saline were done in 13 (62%) cases. Nineteen (90%) shunts were patent at the time of definite vascular repair while 1 (5%) patient had amputation and 1 (5%) died before definite vascular repair.
Conclusion: Temporary vascular shunt is an effective adjunct in the management of extremity vascular trauma for gaining time before definite vascular repair and in saving limb and life.