BIBLIOMETRIC ANALYSIS OF RESEARCH ON THE MANAGEMENT OF IATROGENIC VASCULAR INJURIES DURING GENERAL SURGICAL...

Iatrogenic vascular injuries (IVIs) are rare but severe complications of general surgical procedures, often leading to hemorrhage, ischemia, and increased healthcare costs. Despite technological advances in imaging and endovascular management, IVIs remain a critical challenge. Current research is fragmented, and no comprehensive bibliometric analysis has mapped global trends in this field.

This study aimed to analyze global research output on the management of IVIs during general surgical procedures between 2000 and 2025, focusing on publication trends, authorship, institutional collaborations, and thematic evolution.

A bibliometric analysis was conducted using PubMed, Medline, and Embase databases. Publications from 2000-2025 were retrieved using predefined search terms related to IVIs and general surgery. Only original research, reviews, and case reports were included. Data were screened following PRISMA guidelines, duplicates removed, and metadata analyzed with VOSviewer and Bibliometrix to assess publication trends, co-authorship, institutional networks, and keyword clusters. Bradford's and Lotka's Laws were applied to examine journal and author productivity.

A total of 716 publications met inclusion criteria. Annual output increased from fewer than 20 papers per year in the early 2000s to peaks in 2015 (57 publications) and 2020 (61 publications). Annals of Vascular Surgery (48 articles), Vascular and Endovascular Surgery (33), and Catheterization and Cardiovascular Interventions (25) were the most productive journals, confirming strong adherence to Bradford's Law. Authorship analysis revealed that 96.4% of authors contributed only a single paper, consistent with Lotka's Law, while a small number of researchers, such as Bergqvist, Agarwal, and Kumar, demonstrated sustained contributions. The United States led global output (340 articles), followed by Italy (234) and China (161), although multinational collaboration rates remained below 11%. Keyword mapping identified three phases of research: early focus on open surgical complications (2000-2009), transitional adoption of endovascular and imaging techniques (2010-2013), and recent emphasis on long-term outcomes and minimally invasive strategies (2014-2025).

Research on IVIs during general surgery has expanded significantly over the past two decades, driven by advances in endovascular repair and imaging. However, output remains highly concentrated in specialized journals and dominated by single-country contributions, with limited global collaboration and underrepresentation of preventive strategies. Future research should prioritize multinational registries, standardized reporting, and comparative studies of prevention and long-term outcomes. Emerging technologies such as artificial intelligence and simulation-based training offer promising directions for reducing IVI risk and improving patient safety.