To the Editor.—Reduction of warm ischemia time is important for both the successful revascularization and replantation of injured extremities, and it is considered the critical determinant of ultimate limb salvage. Several authors have advocated the use of temporary arterial shunts to minimize ischemic time while allowing unhurried débridement and fracture stabilization before definitive vascular repair.1 Most of the shunts used today must be kept in the correct position by clamps or "keepers"; however, these external fixing appliances have been shown not only to contribute to vessel wall injury but also to become dislodged occasionally and to impede other aspects of the operative procedure.
The Pruitt-Inahara shunt (Ideas for Medicine Inc, Tampa, Fla) avoids those problems and allows unimpeded and unhurried completion of the procedure. The shunt was developed and initially used as a carotid artery shunt. The use of this shunt in difficult elective vascular reconstructions has been
HOWE HR, PENNELL TC. A Superior Temporary Shunt for Management of Vascular Trauma of Extremity. Arch Surg. 1986;121(10):1212. doi:10.1001/archsurg.1986.01400100124024