Iatrogenic Vascular Injuries in Australia and New Zealand: A 15 Year Study From the Australasian Vascular Audit.

BACKGROUND: Iatrogenic vascular injuries (IVIs) are increasingly encountered in clinical practice. Contemporary population-level data describing these injuries in Australia and New Zealand are limited. METHODS: A retrospective observational study was performed using prospectively collected data from the Australasian Vascular Audit. All cases coded as 'trauma (iatrogenic)' requiring operative or endovascular intervention between January 2010 and December 2024 were included. Patient demographics, anatomical sites of injury, operative procedures, urgency, and in-hospital outcomes were analysed. Temporal trends were assessed using negative binomial regression and Cochran-Armitage trend testing. RESULTS: A total of 4559 iatrogenic vascular injuries were identified over the 15-year study period. Median patient age was 66 years, with a slight male predominance (54.0%). The most frequently injured vessels were the common femoral artery (20.6%), external iliac artery (8.6%), and brachial artery (5.6%). Local repair without bypass was the most common operative strategy (43.5%). Overall in-hospital mortality was 6.5%, while major limb amputation was uncommon (0.44%). A significant increase in annual case numbers was observed, corresponding to an approximate 1.5% increase per year (p < 0.001). Common femoral, radial and brachial artery injuries increased significantly over time, whereas carotid artery injuries declined. CONCLUSION: Iatrogenic vascular injuries requiring surgical intervention are increasing in Australia and New Zealand and represent a growing component of acute vascular surgical workload. Despite low amputation rates, associated mortality remains substantial, highlighting the need for ongoing surveillance, preventive strategies, and appropriate vascular workforce planning.