title: Endovascular technique for arterial shunting to prevent intraoperative ischemia.
abstract: OBJECTIVE
  The use of an intraoperative shunt is an established technique used to reduce the ischemic time after acute arterial obstruction or in the prevention of hypoperfusion due to complex open vascular or endovascular operative procedures. To date, described methods of temporary extremity blood perfusion have required open surgical techniques.
  
  
  METHODS
  An endovascular shunt (ES) was formed by connecting two introducer sheaths to each other, one positioned proximal and one distal to an arterial obstruction. The ES method was used in patients considered to be at high risk for prolonged lower limb ischemia in conjunction with a vascular procedure and where shunt creation by open surgical technique was not considered to be a practical alternative. The flow capacity of the ES was defined in a desktop model.
  
  
  RESULTS
  The ES method was used clinically in 15 vascular interventions including eight complex endovascular aortic procedures, three open aortic operations, and four procedures for acute limb ischemia. The shunts were functional in all patients and there were no shunt occlusions. Postoperatively, there were no evident clinical reperfusion injuries. Flow analysis revealed that the ES had a flow capacity of 73% flow capacity compared to a Pruitt-Inahara shunt.
  
  
  CONCLUSIONS
  A new method of temporary blood shunting in connection to vascular procedures has been demonstrated.
authors.affiliation: Department of Vascular Surgery and Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital and Academy, Blå Stråket 5, S-413 45 Gothenburg, Sweden. Electronic address: klas.osterberg@vgregion.se.
authors.forename: K
authors.initials: K
authors.lastname: Österberg
authors.affiliation: Department of Radiology, Institution of Clinical Sciences, Sahlgrenska University Hospital and Academy, Gothenburg, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Falkenberg
authors.affiliation: Vascular Center, Skåne University Hospital, Malmö, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Resch
mesh_terms: D000208:Acute Disease; D001011:Aorta / Q000503:physiopathology / Q000601:surgery*; D057510:Endovascular Procedures; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D035002:Lower Extremity / Q000098:blood supply*; D010477:Perfusion / Q000379:methods*; D012039:Regional Blood Flow; D012189:Retrospective Studies; D013548:Sweden; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects*
keywords: Endovascular technique; Ischemia–reperfusion injury; Vascular shunting; Vascular surgical technique