Performance of a novel temporary arterial shunt in a military-relevant controlled hemorrhage swine model.

The Journal of Trauma and Acute Care Surgery
Kyle S StigallDavid S Kauvar

Abstract

In military trauma, temporary vascular shunts restore arterial continuity until delayed vascular reconstruction, often for a period of hours. A novel US Air Force-developed trauma-specific vascular injury shunt (TS-VIS) incorporates an accessible side port for intervention or monitoring, which may improve patency under adverse hemodynamic conditions. Our objective was to evaluate TS-VIS patency in the setting of volume-limited resuscitation from hemorrhagic shock. Female swine (70-90 kg) underwent 30% hemorrhage and occlusion of the left external iliac artery for 30 minutes. Animals were allocated to one of three groups (n = 5 per group) by left external iliac artery treatment: Sundt shunt (SUNDT), TS-VIS with arterial pressure monitoring (TS-VIS), or TS-VIS with heparin infusion (10 μ/kg per hour, TS-VISHep). Animals were resuscitated with up to 3 U of whole blood to maintain a mean arterial pressure (MAP) of >60 mm Hg and were monitored for 6 hours. Bilateral femoral arterial flow was continuously monitored with transonic flow probes, and shunt thrombosis was defined as the absence of flow for greater than 5 minutes. No intergroup differences in MAP or flow were observed at baseline or following hemorrhage. Animals were hypot...Continue Reading

References

Jul 1, 1989·The Journal of Surgical Research·A ChervuW J Quinones-Baldrich
Jun 27, 2006·Annals of Vascular Surgery·W Darrin ClouseDonald H Jenkins
Mar 27, 2007·Journal of the American College of Surgeons·W Darrin ClouseNorman M Rich
Jan 11, 2011·Annals of Surgery·Joseph M WhiteTodd E Rasmussen
Dec 30, 2015·The Journal of Trauma and Acute Care Surgery·Kenji InabaUNKNOWN Multicenter Shunt Study Group
Dec 29, 2016·The Journal of Trauma and Acute Care Surgery·Sarah MathewMark J Seamon
Aug 5, 2017·Frontiers in Surgery·Adham N Abou AliEfthymios D Avgerinos
Sep 3, 2019·Annals of Vascular Surgery·David S KauvarThomas J Walters

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