The Vascular Interventions and Surgery in Trauma Audit (VISTA): A Prospective National Service Evaluation of Vascular Trauma in the UK
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: The frequency, operative management, and outcomes for patients with traumatic vascular injury in the UK are unknown. The Vascular Interventions and Surgery in Trauma Audit (VISTA) aimed to describe the contemporary landscape of UK vascular trauma compared with retrospective data from the National Vascular Registry (NVR). METHODS: A prospective, resident led service evaluation was conducted across UK major trauma centres (MTCs) delivered by the National Trauma and Research Innovation Collaborative and the Vascular and Endovascular Research Network. The evaluation included patients with traumatic injuries to named vessels falling under the management remit of vascular surgery, identified radiologically or intra-operatively, between March and October 2022 and comparative NVR data from 2017 to 2022. RESULTS: VISTA captured 302 patients with 339 vascular injuries from 27 MTCs. The median patient age was 41 years (interquartile range 26, 59) and 78.8% (n = 238) were men. Most injuries resulted from road traffic collisions (42.4%, n = 128). Overall, 38 patients (12.6%) were shocked on arrival at the emergency department. Two thirds of patients (65.6%, n = 198) required surgery, of whom 140 (70.7%) had an open procedure and 58 (29.3%) an endovascular intervention. Open procedures included 86 (61.4%) extremity interventions (including six [4.3%] primary amputations), four (2.9%) carotid repairs, four (2.9%) caval repairs, and two (1.5%) aortic repairs. Endovascular procedures included 23 (40%) thoracic endovascular aortic repairs, two (3%) extremity stents, and one (2%) extremity embolisation. The secondary amputation rate was 12% (10 of 86). Extrapolated annual VISTA data suggest the NVR fails to capture 58% of aortic injuries and 42% of extremity vascular injuries requiring intervention. CONCLUSION: UK wide registries do not accurately capture surgical volume and outcomes for vascular interventions following trauma. Granular national datasets are required to establish evidence based key performance indicators for life and limb salvage following vascular trauma to improve services, promote safety, and assure patient outcomes.
Authors: Katherine-Helen Hurndall, Robert Leatherby, Sam Waton, Ian Hunter, Arun Pherwani, Simon Glasgow, Ross Davenport, Brenig L. Gwilym, Nina Al-Saadi, Graeme K. Ambler, Ruth A. Benson, Panagiota Birmpili, David C. Bosanquet, Paris Cai, Nikesh Dattani, Tamer El-Sayed, Emma Hawthornthwaite, Louise Hitchman, Sandip Nandhra, Sarah Onida, Athanasios Saratzis, Joseph Shalhoub, Aminder Singh, Bryce Renwick, Martin Gannon, Akshay Sethi, John Taylor, Rachel McKinney, James Cisack, Donagh Healy, Sifat Khan, Tasleem Akhtar, Rachael Coulson, Daclan Beattie, Tom Barker, Mycroft Halliwell-Ewen, Angus Selby, Timothy Beckitt, Ewa Zywicka, Ankita Chopra, Anthony Wijaya, Simon Kreckler, Mo Chowdhury, Guglielmo La’Torre, Jacob Begbie, Lewis Meecham, Madlen Dewi, Ghali Salahia, Nicholas Matharu, Alexander Sergiou, Mark Mobley, Stuart Suttie, Dominic Pang, David Strachan, Dominic McGowan, Adam Johnson, Stephen Davison, Dan Ablett, James Vassallo, David Kingsmore, Martyn Eckersley, Maaz Syed, Joel Norton, Michael Ryder, Ian Chetter, Raghu Lakshminarayan, Abduraheem Mohamed, Arthur Lim, Marawan Elfarargy, Timothy Stansfield, Ketan Dhital, Emily Chan, Ebrahim Palkhi, Jim Zhong, Duncan Bew, Majd Alobeid, David Nicholson-Thomas, Kamran Khan, Nyagan Kalam-Sakit, Konrad Csenki, Sandip Nandhra, Lawrence Ugwumba, Demetris Tsiakkis, Murtaza Salem, Lauren Blackburn, David Sidloff, Hanish Nagar, Dominic Howard, Xun Luo, Shoaib Hussain, Sarah Nduwayo, Robert Faulconer, Adam Tam, Ahmed Abdelrahim, Paul Jenkins, Sharath Hosmane, Stacie Hodge, Abeera Qayyum, Mohammad Nazir, Thamer Babiker, Ross Davenport, Harkiran Sagoo, Kirtan Patel, William Rea, Nimesh Shah, Jared Wohlgemut, Shah Nawaz, Nabeeh Abouelmagd, Banjamin Patterson, Andrew Nickinson, Stephen Green, Ibrahim Enemosah, Sachin Modi, Gary Maytham, James Budge, Joseph Shalhoub, Matyas Fehervari, Giovanni Dallamico, Manal Ahmad, Anthony Jaipersad, Ala Hassouneh, Uzma Sadia, James Davies
Institutions: Queen Mary University of London, Blizard Institute, Imperial College London, St George's Hospital, City St George's, University of London, Royal College of Surgeons of England, Musgrove Park Hospital, Taunton & Somerset NHS Foundation Trust, Somerset NHS Foundation Trust, University Hospitals of North Midlands NHS Trust, Keele University, Imperial College Healthcare NHS Trust
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,000
Funder: Circulation Foundation
OpenAlex ID: W4413510021