Guidelines and Evidence

in Vascular Trauma

Applied

Type

Modification

Confidence

90%

Created

Apr 26, 2026

Evidence

1 source

Rationale

The stale guideline replacement target instructions specify that aha 2022 isselbacher (and the co-cited Isselbacher EM, Preventza O, Hamilton Black J 3rd, et al) should be replaced by the superseding AHA guideline when the same claim is supported. Both prior citations referred to the same ACC/AHA aortic disease guideline for the same claim about TEVAR surveillance and aortic management principles. The new guideline (PMID 36480976) supersedes these and adds the multidisciplinary team and specialized center emphasis, which is a meaningful update worth reflecting in the text. No other content changes are warranted.

Evidence

AHA. ACC/AHA Aortic Disease Guidelines: What Was Simple Is Now Complex-Moving to Multidisciplinary Teams, Specialized Centers. J Am Coll Cardiol. 2022. PMID: 36480976. DOI: 10.1016/j.jacc.2022.11.007.
Verified source
PubMedDOI

Content Changes

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**Key guidance documents (high yield)**

- **Extremity vascular trauma evaluation and management** principles (hard signs → immediate management; ankle-brachial index (ABI)/API-based screening; computed tomography angiography (CTA)/digital subtraction angiography (DSA) planning) are summarized in EAST guidance and remain foundational. [@feliciano2011]
- **Pelvic trauma hemorrhage control** (including embolization pathways) is addressed in WSES guidance. [@coccolini2017-wses]
- **resuscitative endovascular balloon occlusion of the aorta (REBOA) governance and system implementation** in civilian trauma systems is outlined in the ACS-COT/NAEMSP joint statement (patient selection, training, QA). [@bulger2019]
- **Descending thoracic aorta disease/thoracic endovascular aortic repair (TEVAR)** guidance informs blunt thoracic aortic injury (BTAI) technical decisions and complication mitigation strategies. [@riambau2017]
- **ACC/AHA aortic disease guideline** provides contemporary standards relevant to TEVAR imaging surveillance and aortic management principles applicable to traumatic aortic injury follow-up.follow-up, [@isselbacher2022]with [@aha2022-isselbacher]updated emphasis on multidisciplinary teams and specialized aortic centers. [@aha2026]

**Cross-references**

- See [[endovascular trauma management (EVTM)]] for hybrid workflows, balloon occlusion, and endovascular adjunct integration into damage control resuscitation. [@trauma2016]
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