Published: 2021-02-25

Trends and outcomes in the management of vascular trauma: institutional experience at a level 1 trauma center

Justin Weller, Madison Bowles


Background: Vascular trauma remains a complex area for clinicians and its management is constantly evolving. The increasing use of endovascular modalities and non-operative management has led to significant changes in the treatment of vascular trauma. The aim of this study was to identify the current management and outcomes of vascular trauma at a Level 1 trauma centre in Queensland, Australia and compare this with the current literature.

Methods: All individuals who presented to GCUH with vascular injuries between January 2014 and December 2019 were identified from the GCUH trauma database. A descriptive analysis was performed on this cohort.

Results: 213 patients were identified in our cohort; 51 were managed non-operatively, 121 were managed with open surgery, 37 were managed endovascularly and 4 had a combination of open and endovascular intervention.

Conclusions: The proportion of vascular injuries managed with endovascular interventions or non-operatively has increased within the study period. This study shows that the trends of management for vascular trauma in Australia are consistent with recent international literature.


Vascular trauma, Intervention, Endovascular, Mortality

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Rohrer M. Vascular Trauma. Society for Vascular Surgery. vascular-conditions/vascular-trauma. 2020. Accessed March 10, 2020.

Friend J, Rao S, Sieunarine K, Woodroof P. Vascular trauma in Western Australia: a comparison of two study periods over 15 years: Vascular trauma in Western Australia. ANZ J Surg. 2016;86:173-8.

Perkins ZB, De'Ath HD, Aylwin C, Brohi K, Walsh M, Tai NRM. Epidemiology and Outcome of Vascular Trauma at a British Major Trauma Centre. Eur J Vascular Endovascular Surg. 2012;44:203-9.

Loh SA, Rockman CB, Chung C, BS. Existing trauma and critical care scoring systems underestimate mortality among vascular trauma patients. Journal of Vascular Surgery. 2011;53:359-66.

Sugrue M, Caldwell EM, Damours SK, Crozier JA, Deane SA. Vascular injury in Australia. Surg Clin North Am. 2002;82(1):211-19.

DiMaggio C, Ayoung-Chee P, Shinseki M. Traumatic injury in the United States: In-patient epidemiology 2000-2011. Injury. 2016;47:1393-403.

Oliver JC, Gill H, Nicol AJ, Edu S, Navsaria PH. Temporary vascular shunting in vascular trauma: A 10-year review from a civilian trauma centre. South Afr J Surg. 2013;51:6-10.

Jacks R, Degiannis E. Endovascular Therapy and Controversies in The Management of Vascular Trauma. Scandinavian J Surg. 2014;103:149-55.

Starnes BW, Arthurs ZM. Endovascular Management of Vascular Trauma. Sage J. 2006;18(2).

Branco BC, DuBose JJ, Zhan, Luke X. Trends and outcomes of endovascular therapy in the management of civilian vascular injuries. J Vascular Surg. 2014;60:1297-307.

Richmond B, Judhan R, Sherrill W. Trends and Outcomes in the Operative Management of Traumatic Vascular Injuries: A Comparison of Open versus Endovascular Approaches. Am surgeon. 2017;83:495-501.

Weinberg JA, Moore AH, Magnotti LJ, Teague RJ, Ward TA, Wasmund JB, et al. Contemporary management of civilian penetrating cervicothoracic arterial injuries. J Trauma Acute Care Surg. 2016;81:302-6.

Xenos ES, Minion DJ, Davenport DL, Hamdallah O, Abedi NN, Sorial EE, et al. Endovascular versus open repair for descending thoracic aortic rupture: Institutional experience and meta-analaysis. Eur J Cardiothoracic Surg. 2009;35:282-6.

Barmparas G, Inaba K, Talving P, David JS, Lam L, Plurad D, et al. Pediatric vs adult vascular trauma: an National Trauma Databank review. J Pediatr Surg. 2010;45:1404-12.

Gupta R, Rao S, Sieunarine K. An epidemiological view of vascular trauma in Western Australia: A 5-year study. ANZ J Surg. 2001;71:461-6.

Ecklund JM, Moores LE. Neurotrauma Management for the Severely Injured Polytrauma Patient. 1st 2016 ed. Cham: Springer. 2017.

Kobata H. Department of Neurosurgery, Osaka Mishima Emergency Critical Care Center. Diagnosis and Treatment of Traumatic Cerebrovascular Injury: Pitfalls in the Management of Neurotrauma. Neurologia medico-chirurgica. 2017;57:410-7.

Jacks R, Degiannis E. Endovascular Therapy and Controversies in The Management of Vascular Trauma. Scandinavian J Surg. 2014;103:149-55.

Desai SS, DuBOse JJ, Parham CS, Charlton-Ouw KM, Vlaes J, et al. Outcomes after endovascular repair of arterial trauma. J Vascular Surg. 2014;60:1309-14.

Stawicki SPA. Trends in nonoperative management of traumatic injuries-A synopsis. Int J Cri Illness Injury Sci. 2017;7:38-57.

Wahlgren CM, Riddez L. Penetrating Vascular Trauma of the Upper and Lower Limbs. Current Trauma Rep. 2016;2:11-20.

Alderazi YJ, Cruz GM, Kass-hout T, Prestigiacoma CJ, Duffis EJ, Gandhi CD. Endovascular therapy for cerebrovascular injuries after head and neck trauma. Sage J. 2015;17:258-69.

Karaolanis G, Maltezos K, Bakoyiannis C, Georgopoulos S. Contemporary strategies in the management of civilian neck Zone II vascular trauma. Frontiers Surg. 2017.

Irace L, Laurito A, Venosi S, Irace FG, Malay A, Gossetti B. Mid and lon term results of endovascular treatment in thoracic aorta blunt trauma. Sci World J. 2012;12.

Xenos ES, Abedi NN, Davenport DL, Minion DJ, Hamdallah O, Sorial EE, et al. Meta-analysis of endovascular vs open repair for traumatic descending thoracic aortic rupture. J Vascular Surg. 2008;48:1343-51.