The Allen Brown shunt: a useful option for vascular access

This study analyzes the performance of 273 Allen Brown arteriovenous shunts inserted in the thigh and anastomosed to the superficial femoral artery and either the superficial femoral vein or the long saphenous vein. The median duration of shunt function was 9 weeks (range: 0 to 175 weeks). A significantly longer median function time of 22 weeks was found in patients who had had more than five previous access procedures (p less than 0.02). No other independent variable affecting shunt function time was identified. There were 84 complications (56 due to infection) and 2 deaths in the series. The infection rate was not improved by the use of perioperative antibiotics, with most infections occurring more than 6 weeks after insertion. Since the complication rate for Allen Brown shunts was no greater than that reported for subclavian catheters, and their function no less reliable than that reported for Quinton-Scribner shunts, the Allen Brown shunt is a useful option for short- and medium-term vascular access. It may also be useful for longer-term access in the patient in whom failure of multiple previous access procedures has occurred.