Management of vascular injuries can be one of the most challenging aspects of trauma surgery. The evolution of endovascular therapies has led to advances in vascular surgery. In an effort to integrate these skills into the open surgical specialty, the ESTARS course was developed with the primary goal of providing fundamental endovascular training for trauma surgeons as a basis for seamless management of vascular trauma via open, endovascular, or a hybrid approach.

The ESTARS 2-day course incorporates:

• Pre- and post-test exams
• Pre-course materials
• Modular lectures
• Hands-on exposure to endovascular and open vascular instruments
• The Vascular Intervention System Trainer (VIST) endovascular simulator
• Live animal labs for training and testing

A team of experts teaches the curriculum, which includes endovascular techniques for trauma, review of wires, sheaths, catheters, and specific regional vascular injury management (cervical, abdominal, aortic, pelvis, extremity). Live animal labs integrate femoral arterial access, diagnostic aortography, selective angiography, coil embolization, resuscitative endovascular balloon occlusion of the aorta (REBOA), control of standardized iliac arterial injury, proximal/distal arterial control, and shunt placement.

Validation of this course has demonstrated measurable improvements in key performance metrics in trauma endovascular techniques for early definitive treatment of noncompressible torso hemorrhage. As such, ESTARS shows potential to serve as a model for future competency-based structured training in endovascular trauma skills.