Upper Extremity Hybrid Procedures

in Upper Extremity Arterial Disease

Applied

Type

Addition

Confidence

55%

Created

Mar 19, 2026

Evidence

1 source

Rationale

The integration of Mendes D et al adds a specific clinical application for hybrid techniques in the upper extremity—complex aneurysms spanning multiple arterial segments. This expands the list of indications beyond general multilevel disease. I also expanded the abbreviation LSA to comply with the formatting rules.

Evidence

Mendes D et al. Hybrid Approach of a Complex Aneurysm of the Subclavian-Axillary-Brachial Axis: A Case Report. Vasc Endovascular Surg. 2022. PMID: 35759363.
Verified source
PubMedDOI

Content Changes

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Hybrid approaches combine open exposure/reconstruction with endovascular therapy and are useful when:

- There is **multilevel disease** requiring both inflow correction and distal optimization.
- Open access improves endovascular safety (e.g., difficult arch anatomy, need for controlled access).
- Concomitant procedures are planned (e.g., LSAleft subclavian artery (LSA) revascularization plus endovascular arch/descending thoracic work). [@matsumura2009]
- Complex aneurysmal disease involves the subclavian-axillary-brachial axis, where hybrid exclusion and bypass maintain distal perfusion. [@mendes2022]

**Planning principles**

- Define the dominant failure risk (inflow vs outflow vs embolic source) and sequence steps accordingly.
- Use standardized reporting (primary/assisted/secondary patency and reintervention). [@freischlag2022]

Hybrid revascularization is established in peripheral arterial practice; outcomes depend on lesion complexity and patient selection. [@bisdas2013] [@hybrid2018]
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