SynthesisWorld journal of emergency surgery : WJES2026
Comparison of short-term outcomes in open versus endovascular management of traumatic axillosubclavian arterial injuries in the contemporary era: a systematic review and meta-analysis.
Synthesis in World journal of emergency surgery : WJES, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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7 authors.
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Abstract
backgroundTraumatic axillosubclavian arterial injuries are rare but associated with high morbidity and mortality. Endovascular repair (ER) has emerged as an alternative to open surgery (OS), yet comparative outcome data remain inconsistent. This systematic review and meta-analysis compared short-term outcomes of ER versus OS for these injuries.
methodsThis study followed PRISMA guidelines and was registered in PROSPERO (CRD420251018150). PubMed, Embase, Cochrane Library, and Scopus were searched for studies. Eligible studies included adult patients with blunt or penetrating traumatic axillosubclavian arterial injuries treated with ER or OS. The primary outcome was short-term all-cause mortality (in-hospital or 30-day). Secondary outcomes included upper-extremity amputation, thrombosis of repair, and stroke. Pooled odds ratios with 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity was assessed using the I² statistic. Risk of bias and certainty of evidence were evaluated using ROBINS-I and GRADE.
resultsTwelve retrospective observational studies including 2 854 patients were analyzed. OS was associated with higher mortality compared with ER (OR 2.07, 95% CI 1.46-2.93; p < .001). No significant differences were observed for amputation (OR 1.26, 95% CI 0.59-2.73; p = .55), thrombosis of repair (OR 1.05, 95% CI 0.37-2.94; p = .93), or stroke (OR 1.06, 95% CI 0.69-1.63; p = .78). Certainty of evidence was moderate for mortality and very low for secondary outcomes.
conclusionER is associated with lower short-term mortality compared with OS in patients with traumatic axillosubclavian arterial injuries, with similar rates of amputation, thrombosis, and stroke. These findings are limited by retrospective study designs and potential confounding, highlighting the need for prospective, multicenter studies to validate outcomes and assess long-term durability.
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