Large vascular blunt trauma injury: A multidisciplinary approach for early management

Trauma remains the leading cause of death in young patients, with blunt vascular injuries significantly contributing to mortality through hemorrhagic shock or ischemic complications. Advances in prehospital care, resuscitation, and hemorrhage control have improved early survival, leading to an increasing number of patients admitted with complex blunt vascular lesions. However, early recognition and optimal management remain challenging, and delays in diagnosis or intervention are strongly associated with adverse outcomes. Efficient triage, rapid imaging, and timely multidisciplinary decision-making are critical determinants of survival. This narrative review synthesizes current evidence on the epidemiology, diagnostic strategies, and management of blunt major vessel injuries. It proposes a structured, multidisciplinary care framework, from initial prehospital triage to definitive treatment in specialized trauma centers, anchored in the 2025 ESVS guidelines and from an anesthesiologist-intensivist perspective.