Systematic review and meta-analysis of endovascular repair for traumatic subclavian artery injury.

Abstract

Subclavian artery trauma is relatively rare and may result from blunt or penetrating mechanisms. We aimed to evaluate short- and long-term outcomes in patients with traumatic subclavian injuries treated with endovascular repair. We performed a systematic review and single-arm meta-analysis following the PRISMA guidelines. We included retrospective studies involving endovascular repair for traumatic subclavian injury. We pooled means and proportions using inverse variance and logit transformations and assessed heterogeneity with I statistics. Subgroup analysis based on mechanism of injury (penetrating vs blunt) was performed. We included 13 studies comprising 1105 patients. The pooled early mortality rate was 7%, late mortality was 2%, amputation 3%, and compartment syndrome 5%. The mean length of stay was 10.31 days, and the mean operative time was 112.03 minutes. Thrombosis occurred in 13% of patients, with 7% requiring reintervention. Stenosis was reported in 11%, with 9% undergoing reintervention. Endoleak was observed in 10% of cases, and 7% required reintervention. Penetrating injuries were associated with lower early mortality (P = .0869) and shorter length of stay (P = .0206), with no significant differences in other outcomes. This meta-analysis showed low postoperative complication rates after endovascular repair of subclavian artery trauma. Despite adequate follow-up times, further studies are needed owing to the rarity of the condition and variability in trauma center practices.