UKZN PhD Graduate Advances Life-Saving Insights into Vascular Trauma Care

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A ground-breaking doctoral study by vascular surgeon, Dr Vuyolwethu Ntola, is shedding new light on the management of critically injured trauma patients, offering valuable insights that could improve survival and reduce complications in high-risk cases.

Ntola, who graduated with a PhD in Surgery from the University of KwaZulu-Natal (UKZN), explored the study titled ‘Management of Patients with Vascular Injury in the Context of Polytrauma Requiring Intensive Care Unit (ICU) Admission’. His research was supervised by leading trauma surgeon Professor Timothy Hardcastle.

Trauma remains one of the leading causes of death and disability globally. While high-income countries predominantly see blunt trauma from road traffic collisions, developing regions such as South Africa face a higher burden of penetrating injuries linked to interpersonal violence and crime. Despite this, there has been limited research on vascular trauma patients requiring intensive care.

Ntola’s study addresses this gap by providing a comprehensive, ICU-centred analysis of patients with vascular injuries accompanied by other severe trauma. His research resulted in four publications. The first paper evaluated diagnostic approaches in vascular trauma, highlighting that the choice of tools such as Ankle-Brachial Index (ABI), Extended Focused Assessment with Sonography in Trauma (eFAST), CT Angiography (CTA), Duplex Ultrasound, and Digital Subtraction Angiography (DSA) depends heavily on patient stability, injury location, and available resources.

The second paper examined the epidemiology of vascular trauma among ICU patients in KwaZulu-Natal. Of 2 805 ICU admissions analysed, 153 patients (5.5%) had vascular injuries, with penetrating trauma accounting for nearly two-thirds (64.7%) of cases, emphasising the regional burden of violence-related injuries.

In the third paper, Ntola investigated management strategies and outcomes. A total of 154 arterial and 39 venous injuries were recorded. Open surgical repair emerged as the most common intervention for arterial injuries (50%), while endovascular techniques, used in 23% of cases, were primarily applied in managing aortic injuries through procedures such as Thoracic Endovascular Aortic Repair (TEVAR).

The fourth paper explored the impact of associated non-vascular injuries. Among 212 additional injuries documented, fractures, particularly of the lower limbs, were most common, followed by thoracic injuries, both of which significantly contributed to patient morbidity.

Collectively, the findings emphasise the critical importance of early diagnosis and rapid intervention in preventing limb loss and reducing mortality. The study also highlights how advances such as CT angiography and minimally invasive endovascular techniques are transforming vascular trauma care.

According to Hardcastle, “Dr Ntola’s work provides a rare and valuable perspective focused on ICU-managed vascular trauma patients, an area often underrepresented in research, offering evidence that could inform clinical protocols and improve outcomes in resource-constrained, high-trauma settings. His contribution marks an important step forward in strengthening trauma care systems in KwaZulu-Natal and beyond.”

Words: MaryAnn Francis

Photograph: Sethu Dlamini