Use of temporary intraluminal shunts in selected peripheral arterial injuries.

Successful limb salvage following major peripheral arterial injury is now limited mainly by destruction of nerve, bone, and soft tissue. In some patients prolonged tissue ischemia may be a problem because of delays in treatment caused by associated injuries. In order to minimize tissue ischemia times, temporary arterial shunting was used in selected patients with injuries requiring fracture fixation or extensive debridement. Forty-two patients with major peripheral arterial injuries were seen in 27 months. Thirteen patients, including ten of the 12 with popliteal artery injuries, had placement of a temporary arterial shunt. All shunted patients had successful revascularization and no complications of the shunting occurred. In the total group of 42 there was one death and one below-knee amputation. In patients with extensive but salvageable injuries occurring with peripheral arterial injuries we feel that the use of a temporary arterial shunt is safe and may prevent prolonged severe ischemia.