Temporary intravascular shunts: When are we really using them according to the NTDB?

Chad G. Ball, Andrew W. Kirkpatrick, Ravi R. Rajani, Amy D. Wyrzykowski, Christopher J. Dente, Gary A. Vercruysse, Paul Mcbeth, Jeffrey M. Nicholas, Jeffrey P. Salomone, Grace Rozycki, David V. Feliciano

Research output: Contribution to journalArticle

Abstract

Temporary intravascular shunts (TIVS) are synthetic intraluminal conduits that maintain arterial and/or venous blood flow. This technique can be used for: 1) replantation; 2) open extremity fractures with extensive soft tissue and arterial injuries; or 3) damage control (extremity/truncal). The literature defining TIVS is composed exclusively of small case series (primarily penetrating injuries). Our goal was to identify the injured population who actually undergoes TIVS using the National Trauma Data Bank (2001 to 2005). TIVS were placed in 395 patients (mean Injury Severity Score = 26; initial hemodynamic instability = 24%; mean based deficit = - 7.2; mortality = 14%). Blunt mechanisms caused 64 per cent (251 of 395) of cases. Penetrating injuries were primarily gunshot wounds (97%). Concurrent severe extremity fractures and/or soft tissue defects were present in 185 (74%) blunt-injured patients. Only six of 111 centers performing TIVS used this technique five or more times. Only three centers used TIVS more than 10 times. The volume of TIVS use was similar across the study period (P > 0.05). TIVS is primarily used in blunt motor vehicle collision trauma with concurrent severe extremity fractures and soft tissue injuries. This provides distal perfusion while surgeons assess/fixate the limb. TIVS are placed relatively uncommonly by a large number of trauma centers with a few hospitals using them much more frequently for penetrating injuries.

Original languageEnglish (US)
Pages (from-to)605-607
Number of pages3
JournalAmerican Surgeon
Volume75
Issue number7
StatePublished - Jul 1 2009
Externally publishedYes

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Extremities
Wounds and Injuries
Soft Tissue Injuries
Gunshot Wounds
Open Fractures
Injury Severity Score
Replantation
Trauma Centers
Motor Vehicles
Perfusion
Hemodynamics
Databases
Mortality
Population

ASJC Scopus subject areas

  • Surgery

Cite this

Ball, C. G., Kirkpatrick, A. W., Rajani, R. R., Wyrzykowski, A. D., Dente, C. J., Vercruysse, G. A., ... Feliciano, D. V. (2009). Temporary intravascular shunts: When are we really using them according to the NTDB? American Surgeon, 75(7), 605-607.

Temporary intravascular shunts : When are we really using them according to the NTDB? / Ball, Chad G.; Kirkpatrick, Andrew W.; Rajani, Ravi R.; Wyrzykowski, Amy D.; Dente, Christopher J.; Vercruysse, Gary A.; Mcbeth, Paul; Nicholas, Jeffrey M.; Salomone, Jeffrey P.; Rozycki, Grace; Feliciano, David V.

In: American Surgeon, Vol. 75, No. 7, 01.07.2009, p. 605-607.

Research output: Contribution to journalArticle

Ball, CG, Kirkpatrick, AW, Rajani, RR, Wyrzykowski, AD, Dente, CJ, Vercruysse, GA, Mcbeth, P, Nicholas, JM, Salomone, JP, Rozycki, G & Feliciano, DV 2009, 'Temporary intravascular shunts: When are we really using them according to the NTDB?', American Surgeon, vol. 75, no. 7, pp. 605-607.
Ball CG, Kirkpatrick AW, Rajani RR, Wyrzykowski AD, Dente CJ, Vercruysse GA et al. Temporary intravascular shunts: When are we really using them according to the NTDB? American Surgeon. 2009 Jul 1;75(7):605-607.
Ball, Chad G. ; Kirkpatrick, Andrew W. ; Rajani, Ravi R. ; Wyrzykowski, Amy D. ; Dente, Christopher J. ; Vercruysse, Gary A. ; Mcbeth, Paul ; Nicholas, Jeffrey M. ; Salomone, Jeffrey P. ; Rozycki, Grace ; Feliciano, David V. / Temporary intravascular shunts : When are we really using them according to the NTDB?. In: American Surgeon. 2009 ; Vol. 75, No. 7. pp. 605-607.
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