O64: Aortic Trauma in the UK (UK): Vascular Interventions and Surgery in Trauma Audit (VISTA)

Abstract

Abstract Background In the UK, the incidence, treatment strategies and clinical outcomes for aortic injury are unknown. Stent graft sizing can be challenging in the acute trauma setting which may increase the risk of stent graft complications. VISTA aimed to describe the UK burden and treatment of aortic trauma. Methods Subgroup analysis of a six-month multicentre, prospective audit of vascular injuries at 27 UK Major Trauma Centres by the National Trauma Research & Innovation Collaborative and Vascular & Endovascular Research Network. Results In total, 58 aortic injuries (43 thoracic, 15 abdominal) with 24 interventions (n=23 TEVAR) were analysed. The median age of TEVAR patients was 46 (IQR: 27 - 59) years and 92% were male. The median time to intervention was 288 (IQR: 208 - 722) minutes and 75% of cases were performed for grade 3 and 4 aortic injuries with one simultaneous carotid-subclavian bypass. A consultant vascular surgeon was documented as present in 75% of cases and the post-procedure mortality rate was 8%. Conclusion TEVARs performed for vascular trauma setting are currently excluded from the National Vascular Registry. UK centre performance, device surveillance and long-term outcomes for this patient cohort requires national monitoring to assure patient safety and drive care quality improvements.