Development of a Puncture Technique for Implanting Temporary Vascular Shunts in a Porcine Model

Background: Temporary vascular shunts (TVSs) are an effective tool for rapidly restoring blood flow to a limb or organ that has experienced vascular injury and ischemia and for which revascularization is not an immediate option. Usually, through an opening in the skin, the TVS is positioned within the proximal and distal stumps of the injured vessel, restoring perfusion and stopping the ischemia. The aim of this study is to compare standard TVS technique and a developed puncture technique for implanting TVS and to evaluate the utility and feasibility of this protocol after arterial lesions, in pigs. Methods: Vascular injuries were inflicted in both hind limbs of 30 pigs, and vascular interventions were performed, using standard and puncture TVS. Because each pig was implanted with both types of TVSs, it was possible to simultaneously monitor, analyze, and compare parameters such as, the mean arterial pressure (MAP, inmmHg), blood flow (mL/min), and insertion times, in the same animal. Results: It was observed that the MAP in the limbs recovered and approached systemic MAP, in 100% of the experiments, in both groups. Analysis of the blood flow data showed that this parameter was significantly reduced in the puncture TVS group (110.36 +/- 9.99 mL/min vs. 153.20 +/- 18.57 mL/min, P = 0.001). On the other hand, the insertion time for the standard TVS was significantly greater than that of the puncture shunt (15.32 +/- 3.08 min vs. 10.37 +/- 1.7 min, P = 0.001). Furthermore, it was found that the primary and secondary patency and complication rates were similar for both TVS types. Conclusion: Thus, given the adequate MAP recovery and reduction in implantation time observed in this experimental and in an animal model study, the use of the puncture TVS technique is effective and feasible.