Background: The introduction and widespread adoption of endovascular techniques have revolutionised the practice of vascular surgery. However, the impact of these advancements on the management of vascular trauma has not been thoroughly evaluated. This study aims to provide an overview of management of vascular trauma in the past decade and assess associations with survival and length of stay.
Methods: Procedure, demographic, length of stay (LOS) and survival data between 2014 and 2023 were obtained from the Australian Vascular Audit. Simple linear regression was used to evaluate trends.
Results: From 2014 to 2023, there were 3353 surgical interventions for vascular trauma, with 76.4% of patients being male. Among these interventions, 64.5% were open, 30.3% were endovascular and 5.2% were hybrid procedures. Endovascular treatments were more common for thoracic and lower limb vascular trauma. Upper limb vascular trauma was almost exclusively managed by open surgery. The use of endovascular techniques increased significantly over the 10-year period, particularly from 2020 onwards (p=0.017). There were no significant differences in mortality rates between endovascular, open or hybrid groups. The average LOS did not differ significantly between open and endovascular approaches.
Conclusion: The use of endovascular techniques for vascular trauma has increased significantly, especially from 2020 onwards, without impacting the overall mortality rates. Open procedures remain the most common intervention, but endovascular treatments are being increasingly used for thoracic and lower limb vascular injuries. Despite advancements of these minimally invasive techniques, the mortality rates and the average LOS remains comparable between open and endovascular procedures.