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3 . 2026

Open, endovascular and hybrid treatment modalities for atherosclerotic aortofemoral segment disease (literature review)

Abstract

Background. The growing interest in hybrid techniques for the treatment of aortofemoral disease is driven by the need to optimize revascularization outcomes while maintaining procedural safety. Although open surgical reconstruction has demonstrated durable long-term patency, it is associated with substantial surgical trauma and an increased risk of intra- and postoperative complications, particularly in patients with significant comorbidities. Therefore, the development and refinement of hybrid approaches represent a promising strategy to enhance the safety profile of vascular interventions without compromising their effectiveness.

Objective. To review and analyze current literature data evaluating the efficacy and safety of hybrid techniques in aortofemoral surgery, with particular emphasis on their ability to reduce complication rates while maintaining patency outcomes comparable to open and endovascular interventions.

Material and methods. A comprehensive bibliographic search was conducted in international and national databases including PubMed, Scopus, Web of Science, and eLibrary.ru. Systematic reviews, meta-analyses, and original research articles reporting clinical outcomes, safety profiles, and primary and secondary patency rates of vascular reconstructions for steno-occlusive aortofemoral disease at various follow-up intervals were included in the analysis.

Results. In the treatment of extensive aortofemoral lesions, hybrid procedures demonstrate lower intra- and postoperative complication rates compared with open surgery. Primary and secondary patency rates are comparable to those achieved with open reconstruction and superior to isolated endovascular interventions. Additionally, hybrid approaches exhibit a favorable economic profile due to reduced intensive care requirements, shorter rehabilitation periods, and decreased length of hospital stay.

Conclusion. Hybrid technologies constitute a rational clinical and economic compromise in the management of complex aortofemoral disease. They reduce procedural invasiveness, preserve high long-term patency of reconstructed segments, and optimize overall treatment costs, thereby occupying a key position in contemporary revascularization algorithms for the aortofemoral segment.

Keywords:atherosclerosis; chronic limb-threatening ischemia; bilateral aortofemoral lesion; hybrid interventions

Authors’ contribution. Study conception and design – Parkin P.N., Magomadov Ya.U., Fataliev G.B.; data collection and handling – Parkin P.N.; draft manuscript preparation – Parkin P.N., Fataliev G.B.; manuscript revision – Shubin A.A., Belov Yu.V.

For citation: Parkin P.N., Shubin A.A., Fataliev G.B., Magomadov Ya.U., Belov Yu.V. Open, endovascular and hybrid treatment modalities for atherosclerotic aortofemoral segment disease (literature review). Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2026; 32 (3): 155–63. DOI: https://doi.org/10.33029/1027-6661-2026-32-3-155-163

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CHIEF EDITOR
CHIEF EDITOR
Yuri V. Belov
Academician of the Russian Academy of Sciences Doctor of Medical Sciences, Professor, President of the Russian Society of Angiologists and Vascular Surgeons

 

In accordance with the decision of the Presidium of the Russian Society of Angiologists and Vascular Surgeons, the journal "Angiology and Vascular Surgery" will be named after Academician A.V. Pokrovsky starting from No. 2/2022.

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