Open Access

Yvonne Nicole Gosslau, Edgar Franklin Hernandez Cancino, Tobias Dominik Warm, Athinodoros Alvanidis, Alexander Hyhlik-Duerr

• Objective This study aimed to assess the long-term follow-up outcomes after vascular trauma of the extremities, focusing on reintervention rates and graft patency as primary endpoints. Secondary aims included evaluation of functional outcomes, quality of life, antithrombotic therapy, and pain management needs. Measures Data were derived from the prospective Vascular Trauma Registry Augsburg (vascTR-Aux), including patients with vascular trauma involving the extremities treated at a German Level I trauma center from January 2016 to March 2025. Demographic, clinical, and procedural data were collected. Long-term follow-up included patency assessment, reintervention, functional status, antithrombotic therapy, pain medication, and patient-reported outcomes using the EQ-5D-3L questionnaire. Descriptive and statistical analyses were performed using Python-based tools. Results Out of 189 enrolled patients, 104 had extremity vascular trauma. The cohort was predominantly male (75.9 %) withObjective This study aimed to assess the long-term follow-up outcomes after vascular trauma of the extremities, focusing on reintervention rates and graft patency as primary endpoints. Secondary aims included evaluation of functional outcomes, quality of life, antithrombotic therapy, and pain management needs. Measures Data were derived from the prospective Vascular Trauma Registry Augsburg (vascTR-Aux), including patients with vascular trauma involving the extremities treated at a German Level I trauma center from January 2016 to March 2025. Demographic, clinical, and procedural data were collected. Long-term follow-up included patency assessment, reintervention, functional status, antithrombotic therapy, pain medication, and patient-reported outcomes using the EQ-5D-3L questionnaire. Descriptive and statistical analyses were performed using Python-based tools. Results Out of 189 enrolled patients, 104 had extremity vascular trauma. The cohort was predominantly male (75.9 %) with a mean age of 41.5 years; 21.2 % were under 18 years. Surgical intervention was performed in 52.9 % of cases, while 26 % received conservative treatment. Amputation was required in 8.7 % of cases. Follow-up data were available for 32.7 % of patients, with a mean duration of 51 months in this subgroup. The graft patency rate was 84.6 %, and reintervention occurred in 3.8 %. Despite this, 50 % reported functional impairments, primarily due to concomitant injuries. Analgesic medication was used by 26.9 % of patients at time of follow-up. Antiplatelet therapy was ongoing in 43.8 %, and 9.4 % received anticoagulation. Injuries to the popliteal artery significantly increased the risk of amputation or death (p < 0.05). Other variables like BMI, age, and ASA score showed trends toward poorer outcomes but lacked statistical significance. Conclusion Long-term graft patency following extremity vascular trauma is high, but functional outcomes remain suboptimal for many patients due to mostly non-vascular conditions. Half of those followed reported lasting impairments, and nearly 20 % required regular pain medication at time of follow-up. These findings emphasize the importance of structured, long-term follow-up protocols and individualized antithrombotic management. Proactive follow-up strategies and dedicated registries are essential to improve evidence-based recommendations and optimize outcomes for this distinct patient population.…