Pediatric Vascular Trauma: A Retrospective Study at a Canadian Trauma Center

Background Pediatric vascular trauma may differ fundamentally from that seen in adults in both injury patterns and treatment. Adult-derived registries and management strategies may not accurately reflect pediatric presentations, mechanisms, or outcomes. This knowledge gap underscores the need for specific data to inform the diagnosis, management, and long-term care of vascular injuries. This paper examines the distribution of pediatric vascular injuries at a Canadian level 1 trauma center. Methods We performed a retrospective review of pediatric vascular injuries at a Canadian level 1 trauma center from 2011 to 2020, examining demographics, injury mechanisms, diagnostic approaches, management strategies, and clinical outcomes using trauma registry and electronic medical record data. Results Thirty-nine pediatric patients with named vascular injuries were identified over 10 years. Mean age was 13.2 years, and most (n = 26, 67%) were male. Most injury mechanisms were blunt (n = 26, 67%), most commonly from motor vehicle collisions. Upper extremity vessels were most frequently affected (n=16, 41%). Mean Injury Severity Score was 25.1, with 67% (n=26) severely injured (ISS>16). Injuries were most often identified by operative exploration or Computed Tomography angiography. Management was predominantly non-operative. Surgical interventions were all definitive open surgery with no endovascular interventions. In-hospital mortality was 7.7% (n=3). No amputations occurred. Conclusion Pediatric patients differ from adults in both the distribution and management of vascular injuries, with lower rates of limb loss despite a higher burden of extremity injuries. Management of these injuries in children tended to be non-operative, and where surgical intervention was required, definitive open repair was used. These findings support the need for pediatric-specific data and may inform future efforts to optimize management strategies in this population.