• Anuradha Subramanian, Gary Vercruysse, Christopher Dente, Amy Wyrzykowski, Erin King, and David V Feliciano.
• Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA. asubrama@bmc.edu
• J Trauma. 2008 Aug 1; 65 (2): 316326316-24; discussion 324-6.

BackgroundA 10-year review of temporary intravascular shunts (TIVS) at a regional trauma center.MethodsRetrospective chart review of all patients treated with temporary intravascular shunts from January 1, 1997 to January 1, 2007.ResultsSeven hundred eighty-six patients were treated for vascular injuries. Sixty-seven (9%) had a total of 101 (72 arterial, 29 venous) TIVS placed to facilitate damage control or to allow for reconstruction of Gustilo IIIc fractures or limb replantation. Seven patients who, on trauma day 0, died or had an extremity which was deemed unsalvageable were excluded. Of 60 patients who met inclusion criteria, seven died from TBI (3%), MOF (3%), sepsis (2%), deceleration of care (2%), and loss of airway (2%), which was deemed preventable.ConclusionsTIVS have a shunt thrombosis rate of 5%, amputation rate of 18%, overall survival of 88%, and combination limb/patient survival rate of 73%. TIVS have an established role primarily in patients requiring either "damage control" for exsanguination or temporary vascular conduits during stabilization of Gustilo IIIc fractures. Truncal injuries are associated with the highest mortality likely due to accompanying multisystem trauma.

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