(PC170) Vascular Surgeon Involvement in Vascular Trauma Management: Barriers, Challenges, Concerns, and the Imperative for Integration

Objectives: Effective vascular trauma management often depends on the surgeon's specialty and experience. This survey aims to evaluate vascular surgeons' interest and identify systemic and logistical barriers to their involvement in vascular trauma care.

Methods: A global, de-identified survey was disseminated to vascular surgeons using the REDCap platform, adhering to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). The survey included 130 questions, designed to be completed within 15 minutes.

Results: Sixty-one vascular surgeons from 20 countries participated, with an average of 14 years of practice experience. The majority worked in academic settings and level 1 trauma centers. On average, 80% of vascular trauma cases at these institutions were managed by vascular surgeons. Most participants (89%) were obligated to manage vascular trauma as part of their on-call duties, with nearly half reporting management of 11–20 vascular trauma cases annually. Additionally, 64% were involved in managing pediatric vascular trauma. (Table I: Vascular Surgeons’ Demographics and Institution Type)

Despite their active involvement, only half of the respondents reported dedicated operating room time for vascular trauma outside of elective practice. Approximately half of the institutions included vascular surgery as part of their trauma activation protocols. In 50% of the institutions, vascular surgeons led the management of vascular injuries, while one-third employed shared decision-making policies with other specialties. Notably, 85% of respondents did not receive compensation for taking trauma calls, though 87% expressed a willingness to take home trauma calls if fairly compensated, and 62% were open to in-house calls under similar conditions.

Key barriers to greater involvement included insufficient institutional resources, such as hybrid operating rooms and midlevel practitioner support, as well as the absence of defined multidisciplinary care pathways and gaps in training for vascular trauma management were also noted. Despite these challenges, 74% of respondents were satisfied with their current role and expressed interest in continuing or expanding their involvement in vascular trauma care. (Table II: Vascular Trauma Coverage and Logistics)

Concerns were raised about the preparedness of modern trauma and pediatric surgeons to handle vascular trauma cases. Most respondents (94%) supported increased exposure to vascular trauma cases during vascular surgery training.

Conclusions: Vascular surgeons are highly interested in managing vascular trauma and taking additional trauma calls if adequately compensated. Overcoming barriers, such as limited resources, lack of institutional support and unfair compensations, is imperative to optimize vascular surgeons’ contribution to trauma care and optimize patient outcomes.