Extra-anatomic temporary intravascular shunting to assist with replantation of an amputated hand with prolonged ischemic time

Although temporary intravascular shunting has been reported to assist with hand revascularization and replantation after traumatic amputation, most reports have described using ipsilateral upper limb inflow. We present a case of a traumatic hand amputation in a patient who had presented with 4 to 5 ...

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Main Authors: David de Launay, MD, Sarah Shiga, MD, Matthew Laschuk, MD, Timothy Brandys, MD, Derek J. Roberts, MD, PhD, FRCSC
Format: Article
Language:English
Published: Elsevier 2022-12-01
Series:Journal of Vascular Surgery Cases and Innovative Techniques
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2468428722001459
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author David de Launay, MD
Sarah Shiga, MD
Matthew Laschuk, MD
Timothy Brandys, MD
Derek J. Roberts, MD, PhD, FRCSC
author_facet David de Launay, MD
Sarah Shiga, MD
Matthew Laschuk, MD
Timothy Brandys, MD
Derek J. Roberts, MD, PhD, FRCSC
author_sort David de Launay, MD
collection DOAJ
description Although temporary intravascular shunting has been reported to assist with hand revascularization and replantation after traumatic amputation, most reports have described using ipsilateral upper limb inflow. We present a case of a traumatic hand amputation in a patient who had presented with 4 to 5 hours of warm ischemic time. Because the replantation team believed that extra-anatomic revascularization would be necessary, we performed a novel type of temporary intravascular shunting by connecting two arterial sheaths placed in the ulnar and superficial femoral arteries. This permitted the hand to be successfully replanted away from the inflow source and resulted in a good long-term functional outcome.
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spelling doaj.art-0f2935ef7527473e9b36cafd3957b7b22022-12-28T04:18:48ZengElsevierJournal of Vascular Surgery Cases and Innovative Techniques2468-42872022-12-0184598601Extra-anatomic temporary intravascular shunting to assist with replantation of an amputated hand with prolonged ischemic timeDavid de Launay, MD0Sarah Shiga, MD1Matthew Laschuk, MD2Timothy Brandys, MD3Derek J. Roberts, MD, PhD, FRCSC4Division of Vascular and Endovascular Surgery, Department of Surgery, University of Ottawa, Ottawa, CanadaDivision of Plastic and Reconstructive Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, CanadaDivision of Plastic and Reconstructive Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, CanadaDivision of Vascular and Endovascular Surgery, Department of Surgery, University of Ottawa, Ottawa, CanadaDivision of Vascular and Endovascular Surgery, Department of Surgery, University of Ottawa, Ottawa, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Division of Vascular and Endovascular Surgery, The Ottawa Hospital, Ottawa, ON, Canada; O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada; Correspondence: Derek J. Roberts, MD, PhD, FRCSC, Division of Vascular and Endovascular Surgery, Department of Surgery, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Division of Vascular and Endovascular Surgery, The Ottawa Hospital, Civic Campus, Room A-280, 1053 Carling Ave, Ottawa, ON K1Y 4E9, CanadaAlthough temporary intravascular shunting has been reported to assist with hand revascularization and replantation after traumatic amputation, most reports have described using ipsilateral upper limb inflow. We present a case of a traumatic hand amputation in a patient who had presented with 4 to 5 hours of warm ischemic time. Because the replantation team believed that extra-anatomic revascularization would be necessary, we performed a novel type of temporary intravascular shunting by connecting two arterial sheaths placed in the ulnar and superficial femoral arteries. This permitted the hand to be successfully replanted away from the inflow source and resulted in a good long-term functional outcome.http://www.sciencedirect.com/science/article/pii/S2468428722001459Case reportHandReplantationTemporary intravascular shuntTraumatic amputation
spellingShingle David de Launay, MD
Sarah Shiga, MD
Matthew Laschuk, MD
Timothy Brandys, MD
Derek J. Roberts, MD, PhD, FRCSC
Extra-anatomic temporary intravascular shunting to assist with replantation of an amputated hand with prolonged ischemic time
Journal of Vascular Surgery Cases and Innovative Techniques
Case report
Hand
Replantation
Temporary intravascular shunt
Traumatic amputation
title Extra-anatomic temporary intravascular shunting to assist with replantation of an amputated hand with prolonged ischemic time
title_full Extra-anatomic temporary intravascular shunting to assist with replantation of an amputated hand with prolonged ischemic time
title_fullStr Extra-anatomic temporary intravascular shunting to assist with replantation of an amputated hand with prolonged ischemic time
title_full_unstemmed Extra-anatomic temporary intravascular shunting to assist with replantation of an amputated hand with prolonged ischemic time
title_short Extra-anatomic temporary intravascular shunting to assist with replantation of an amputated hand with prolonged ischemic time
title_sort extra anatomic temporary intravascular shunting to assist with replantation of an amputated hand with prolonged ischemic time
topic Case report
Hand
Replantation
Temporary intravascular shunt
Traumatic amputation
url http://www.sciencedirect.com/science/article/pii/S2468428722001459
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