A swine model of reproducible timed induction of peripheral arterial shunt failure: Developing warning signs of imminent shunt failure

David P. Stonko, MD, MS; Neerav Patel, MD; Joseph Edwards, MD; Hossam Abdou, MD; Eric Lang, BS; Noha N. Elansary, BS; Rebecca Treffalls, BS; Joseph White, MD; Jonathan J. Morrison, MBChB, PhD

JVS - Vascular Science (Jan 2022)

A swine model of reproducible timed induction of peripheral arterial shunt failure: Developing warning signs of imminent shunt failure

David P. Stonko, MD, MS,
Neerav Patel, MD,
Joseph Edwards, MD,
Hossam Abdou, MD,
Eric Lang, BS,
Noha N. Elansary, BS,
Rebecca Treffalls, BS,
Joseph White, MD,
Jonathan J. Morrison, MBChB, PhD

Affiliations

David P. Stonko, MD, MS: Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD; R. Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD
Neerav Patel, MD: R. Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD
Joseph Edwards, MD: R. Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD
Hossam Abdou, MD: R. Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD
Eric Lang, BS: R. Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD
Noha N. Elansary, BS: R. Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD
Rebecca Treffalls, BS: R. Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD
Joseph White, MD: Uniformed Services University of the Health Sciences, Bethesda, MD
Jonathan J. Morrison, MBChB, PhD: R. Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD; Correspondence: Jonathan J. Morrison, MBChB, PhD, R. Adams Cowley Shock Trauma Center, University of Maryland, 22 S Greene St, Baltimore, MD 21201

Journal volume & issue: Vol. 3
pp. 285 – 291

Abstract

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Temporary intravascular shunts are used to maintain perfusion in injured vessels, although failure can be unpredictable and lead to significant morbidity. The aim of the present study was to develop a dose- and timing-controlled swine model of intrinsic shunt failure to facilitate the development of a warning system for impending failure. Ten Yorkshire swine (weight, 56.6 ± 4.2 kg) underwent bilateral Argyle shunt (Cardinal Health, Dublin, OH) placement in the external iliac arteries, with proximal cannulation of the circumflex iliac arteries for infusion of thrombin. The thrombin infusion was randomized to the left or right side for 5000 vs 10,000 U/h. The 5000-U/h group required 2.1 times as long as the 10,000-U/h group to reach failure (mean, 21.8 minutes vs 46.4 minutes; P .05), and the slope of the flow curve became more negative the closer the model was to failure. Overall, this model could be used to develop an alert system to predict for impending shunt failure or the need for intervention.

Published in JVS - Vascular Science

ISSN: 2666-3503 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/jvs-vascular-science

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Abstract

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