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Temporary Intravascular Shunts After Civilian Arterial Injury: A Prospective Multicenter Eastern Association For The Surgery Of Trauma Study, Lily Tung, Jennifer Leonard, Ryan A. Lawless, Alexis Cralley, Richard Betzold, Jason D. Pasley, Kenji Inaba, Jennie S. Kim, Dennis Y. Kim, Kwang Kim, Bradley M. Dennis, Michael C. Smith, Margaret Moore, Christina Tran, Joshua P. Hazelton, Atlee Melillo, Tejal S. Brahmbhatt, Stephanie Talutis, Noelle N. Saillant, Jae Moo Lee, Mark J. Seamon

School of Medicine Faculty Publications

Introduction: We sought to determine the impact of the indication for shunt placement on shunt-related outcomes after major arterial injuries. We hypothesized that a shunt placed for damage control indications would be associated with an increase in shunt-related complications including shunt dislodgement, thrombosis, or distal ischemia. Patients & methods: A prospective, multicenter study (eleven level one US trauma centers) of all adult trauma patients undergoing temporary intravascular shunts (TIVS) after arterial injury was undertaken (January 2017-May 2019). Exclusion criteria included age <15years, shunt placement distal to popliteal/brachial arteries, isolated venous shunts, and death before shunt removal. Clinical variables were compared by indication and shunt-related complications. The primary endpoint was TIVS complications (thrombosis, migration, distal ischemia). Results: The 66 patients who underwent TIVS were primarily young (30years [IQR 22-36]) men (85%), severely injured (ISS 17 [10-25]) by penetrating mechanisms (59%), and had their shunts placed for damage control (41%). After a median SDT of 198min [89-622], 9% experienced shunt-related complications. Compared by shunt placement indication (damage control shunts [n=27] compared to non-damage control shunts [n=39]), there were no differences in gender, mechanism, extremity AIS, MESS score, fractures, or surgeon specialty between the two groups (all p>0.05). Patients with shunts placed for damage control indications had more severe injuries (ISS 23.5 compared to 13; SBP …