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The Optimal Hybrid Revascularization Approach for Multilevel Peripheral Arterial Disease

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Vascular Medicine".

Deadline for manuscript submissions: 30 January 2026 | Viewed by 321

Special Issue Editor


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Guest Editor
Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul 05278, Republic of Korea
Interests: peripheral arterial disease; abdominal aortic aneurysm; varicose vein; deep vein thrombosis; open bypass surgery; endovascular surgery

Special Issue Information

Dear Colleagues,

Hybrid revascularization—combining endovascular and open surgical techniques—has emerged as a promising approach for treating multilevel peripheral arterial disease (PAD). This approach relies on expertise in both endovascular methods and open surgical procedures, with common femoral endarterectomy serving as a cornerstone in the treatment of lower extremity arterial disease.

Our retrospective analysis of seventy-six patients demonstrated a high rate of technical success and limb preservation with hybrid surgery, highlighting the critical role of femoral endarterectomy in treatment. Similarly, a multi-center study involving one hundred and thirty-four patients reported consistently successful procedural outcomes, with sustained vessel patency over time and a strong record of amputation-free survival. These findings reinforce the effectiveness of hybrid revascularization in managing complex peripheral arterial disease and underscore its potential as a reliable therapeutic approach.

These findings suggest that hybrid revascularization is a viable option for managing multilevel PAD, offering favorable outcomes in terms of technical success, limb salvage, and long-term patency. However, to further validate these promising results and refine the use of hybrid techniques in complex PAD cases, larger multi-center studies with extended follow-up are essential. Overall, hybrid revascularization holds significant potential for improving patient outcomes and advancing the treatment landscape for PAD.

Dr. Jin Hyun Joh
Guest Editor

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Keywords

  • peripheral arterial disease
  • revascularization
  • endovascular procedure
  • endarterectomy
  • limb salvage
  • patency
  • hybrid procedures
  • lower extremity
  • stents
  • angioplasty

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Published Papers (1 paper)

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Research

11 pages, 1853 KiB  
Article
EVAR Trends over the Past Decade and Their Impact on Aneurysm Mortality: National Health Insurance Data Analysis
by Sungsin Cho and Jin Hyun Joh
J. Clin. Med. 2025, 14(15), 5277; https://doi.org/10.3390/jcm14155277 - 25 Jul 2025
Viewed by 200
Abstract
Background/Objectives: There are no reports about the nationwide trends in abdominal aortic aneurysm (AAA) repair and mortality rates. This study aims to evaluate the trend in AAA treatment and related mortality, including ruptured AAAs (rAAAs) and intact AAAs (iAAAs) over the last [...] Read more.
Background/Objectives: There are no reports about the nationwide trends in abdominal aortic aneurysm (AAA) repair and mortality rates. This study aims to evaluate the trend in AAA treatment and related mortality, including ruptured AAAs (rAAAs) and intact AAAs (iAAAs) over the last 13 years. Methods: This serial, cross-sectional study investigated the time trends in patients who were treated for an AAA and underwent an aneurysm repair between 2010 and 2022. Data from the Health Insurance Review and Assessment Service (HIRA) and Statistics Korea were used. A linear-by-linear association and Poisson regression analysis were performed to determine the changes in the treatment of AAAs and related mortality. Results: The number of patients with an rAAA increased from 462 in 2010 to 770 in 2022 (relative risk, RR 1.57; p < 0.0001). The number of patients with an iAAA increased from 3685 to 12,399 in the same period (RR 3.16; p < 0.0001). Endovascular aneurysm repair (EVAR) has been more commonly performed since 2011. During the study period, EVAR increased from 406 to 1161 (RR 2.68; p < 0.0001). Although the annual mortality rates after iAAA treatment decreased from 1.4% to 0.7% (mean mortality rate, 1.1%), the mortality rates after rAAA treatment were similar, ranging from 34.6% to 34.2%, during the study period (mean mortality rate, 35.2%). Conclusions: During the last 13 years, the annual number of patients with rAAAs and iAAAs has increased. Since 2011, EVAR has been more commonly performed. The annual iAAA-related mortality rate decreased along with the increasing trend in EVAR. However, the annual rAAA-related mortality rate did not change. Full article
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