Outcomes and Evidence

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**Evidence landscape**

Most endovascular trauma management (EVTM) outcome data are **observational** (registries, administrative datasets, and single-center series). Interpretation requires attention to indication, timing, comparator selection, and survivorship bias. [@trauma2016-aorta] [@matsumura2020]

**resuscitative endovascular balloon occlusion of the aorta (REBOA) outcomes**

- Registries demonstrate feasibility and define complication patterns; outcome signals vary by indication and practice environment. [@trauma2016-aorta]
- Comparative observational analyses versus resuscitative thoracotomy (RT) show mixed results and are highly selection-dependent.selection-dependent [@brenner2018-survival][@brenner2018-survival]. Recent registry data comparing Zone 1 REBOA to RT for patients in severe hemorrhagic shock suggest potential survival benefits in specific cohorts, though the risk of confounding by indication persists in these non-randomized comparisons [@cralley2026-zone].

**Hybrid/endovascular strategy outcomes (what “success” means)**

Beyond survival, meaningful endpoints include:

- Time to hemorrhage control
- Blood product utilization
- Organ failure and ischemic complications (renal/visceral/limb)
- Need for fasciotomy or access repair
- Limb salvage and functional outcome (especially in extremity/junctional trauma). [@rasmussen2011-vascular]

**Why registries remain central**

Given case heterogeneity and low event frequency at single centers, multi-institution registries are important for benchmarking, governance, and complication surveillance. [@mani2020]

See also: [[Vascular Trauma|Ch. 15]] for extremity injury outcomes and shunt/bypass benchmarks.