ABSTRACT
Trauma is the fourth leading cause of all civilian deaths in the United States and the leading cause of death among children and adults under age 45.1 Many victims have multiple injuries involving major vascular structures. Major injury to thoracic outlet and neck vascular structures can occur in virtually any environment, but the greatest incidence occurs in urban areas, where violence is endemic. Although victims of trauma frequently have multiple injuries, wounds of major vessels are the sole cause or the major contributing cause of many of the deaths. Penetrating trauma in combination with an increase in high-energy road trac accidents has resulted in an increase in major vascular trauma.2 Outcomes aer vascular trauma in terms of survival have been reported to be better in urban areas than in rural.2 is dierence is thought to be due to several factors, but mostly related to prolonged transfer times in the rural setting.
