Endovascular as an open adjunct: use of hybrid endovascular treatment in the SFA.

While open or endovascular techniques for treatment of the superficial femoral artery continue to dominate the care of most patients, there are clearly patients who benefit from a combination of these approaches. Typically these patients require treatment of more than a single level of disease. In these cases, endovascular treatment of one level is combined with surgical treatment at a second level of disease. Most commonly these involve surgical treatment of common femoral artery disease with endovascular treatment of the superficial femoral artery on either side or endovascular treatment of the superficial femoral artery combined with distal origin vein bypass. These approaches allow care to be delivered in a single setting, avoiding the issues of staged procedures. Although the published results from hybrid treatment are limited, the obvious patient benefit ensures that these techniques will continue to be important for vascular patient care.