The journal of trauma and acute care surgery · 2026
Impact of utilization of temporary vascular shunts on outcomes in traumatic peripheral artery repairs: An 11-year review of the PROOVIT registry.
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Nekooei Negar, Bent Christine I, Brabender Danielle E, Wang Justin L, Prasad Ajay N, Siletz Anaar, Matsushima Kazuhide, Inaba Kenji, Dubose Joseph, Martin Matthew J, AAST PROOVIT study group, Los Angeles, California
Аннотация
BACKGROUND: Temporary vascular shunts (TVS) are used for initial stabilization and delayed arterial repair, but their overuse may worsen outcomes. This study evaluates the impact of TVS on reintervention and amputation rates following peripheral arterial repair (PAR).
METHODS: Retrospective analysis (2012-2023) of the PROspective Observational Vascular Injury Treatment (PROOVIT) registry. Patients who underwent PAR were categorized into two groups: TVS before PAR versus immediate repair (IR). Propensity score matching (1:3) balanced patient characteristics and injury severity. The primary outcome was reintervention, with secondary outcomes including amputation, thrombosis, and length of stay.
RESULTS: Among 1,182 PAR patients, 67 (5.7%) received TVS. TVS was most commonly placed in the femoral (42%), brachial (30%), and popliteal arteries (15%). After matching, 67 TVS patients were compared with 201 no-TVS (IR) patients. Reintervention rates were comparable (13.6% vs. 15.9%, p=0.655), as were amputation (1.5% vs. 9%, p=0.051) and thrombosis (9% vs. 6%, p=0.40). In addition, median length of stay was similar (12 vs. 9 d, p=0.243) within cohorts.
CONCLUSIONS: TVS did not significantly impact reintervention, amputation, thrombosis, or length of stay following PAR. TVS and delayed repair achieved comparable outcomes compared with IR of peripheral arterial injuries. (J Trauma Acute Care Surg 2026;00:000-000 Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved.).
LEVEL OF EVIDENCE: Therapeutic/Care Management; Level III.
METHODS: Retrospective analysis (2012-2023) of the PROspective Observational Vascular Injury Treatment (PROOVIT) registry. Patients who underwent PAR were categorized into two groups: TVS before PAR versus immediate repair (IR). Propensity score matching (1:3) balanced patient characteristics and injury severity. The primary outcome was reintervention, with secondary outcomes including amputation, thrombosis, and length of stay.
RESULTS: Among 1,182 PAR patients, 67 (5.7%) received TVS. TVS was most commonly placed in the femoral (42%), brachial (30%), and popliteal arteries (15%). After matching, 67 TVS patients were compared with 201 no-TVS (IR) patients. Reintervention rates were comparable (13.6% vs. 15.9%, p=0.655), as were amputation (1.5% vs. 9%, p=0.051) and thrombosis (9% vs. 6%, p=0.40). In addition, median length of stay was similar (12 vs. 9 d, p=0.243) within cohorts.
CONCLUSIONS: TVS did not significantly impact reintervention, amputation, thrombosis, or length of stay following PAR. TVS and delayed repair achieved comparable outcomes compared with IR of peripheral arterial injuries. (J Trauma Acute Care Surg 2026;00:000-000 Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved.).
LEVEL OF EVIDENCE: Therapeutic/Care Management; Level III.