Peripheral artery disease (PAD) is a common vascular condition affecting over 200 million people worldwide. It is primarily characterized by stenosis or occlusion of peripheral arteries due to atherosclerosis. The infrainguinal segment is frequently involved in PAD, making revascularization decisions for infrainguinal arterial disease (IAD) complex. Multiple factors, including the patient’s condition and anatomical characteristics, must be carefully considered when determining the optimal treatment approach. Once these factors are evaluated, the first revascularization strategy is selected from among open, endovascular, or hybrid modalities, based on high-level evidence. Endovascular therapy is widely accepted as the standard treatment for simple IAD, with balloon angioplasty and stenting being the commonly used techniques.However, advancements in endovascular techniques have enabled the treatment of increasingly complex lesions. Additionally, drug-based technologies have enhanced the durability of treatment outcomes, including improvements in primary patency rates and freedom from target lesion revascularization. Similar to surgical endarterectomy, percutaneous atherectomy has been developed to remove atherosclerotic plaques and mitigate intimal calcification. The purpose of this paper is to present an algorithm for revascularization of IAD through a comprehensive review of studies comparing the outcomes of various treatment modalities.

Peripheral artery disease (PAD) is a common vascular condition affecting over 200 million people worldwide. It is primarily characterized by stenosis or occlusion of peripheral arteries due to atherosclerosis. The infrainguinal segment is frequently involved in PAD, making revascularization decisions for infrainguinal arterial disease (IAD) complex. Multiple factors, including the patient’s condition and anatomical characteristics, must be carefully considered when determining the optimal treatment approach. Once these factors are evaluated, the first revascularization strategy is selected from among open, endovascular, or hybrid modalities, based on high-level evidence. Endovascular therapy is widely accepted as the standard treatment for simple IAD, with balloon angioplasty and stenting being the commonly used techniques.However, advancements in endovascular techniques have enabled the treatment of increasingly complex lesions. Additionally, drug-based technologies have enhanced the durability of treatment outcomes, including improvements in primary patency rates and freedom from target lesion revascularization. Similar to surgical endarterectomy, percutaneous atherectomy has been developed to remove atherosclerotic plaques and mitigate intimal calcification. The purpose of this paper is to present an algorithm for revascularization of IAD through a comprehensive review of studies comparing the outcomes of various treatment modalities.

Peripheral artery disease (PAD) is a common vascular condition affecting over 200 million people worldwide. It is primarily characterized by stenosis or occlusion of peripheral arteries due to atherosclerosis. The infrainguinal segment is frequently involved in PAD, making revascularization decisions for infrainguinal arterial disease (IAD) complex. Multiple factors, including the patient’s condition and anatomical characteristics, must be carefully considered when determining the optimal treatment approach. Once these factors are evaluated, the first revascularization strategy is selected from among open, endovascular, or hybrid modalities, based on high-level evidence. Endovascular therapy is widely accepted as the standard treatment for simple IAD, with balloon angioplasty and stenting being the commonly used techniques.However, advancements in endovascular techniques have enabled the treatment of increasingly complex lesions. Additionally, drug-based technologies have enhanced the durability of treatment outcomes, including improvements in primary patency rates and freedom from target lesion revascularization. Similar to surgical endarterectomy, percutaneous atherectomy has been developed to remove atherosclerotic plaques and mitigate intimal calcification. The purpose of this paper is to present an algorithm for revascularization of IAD through a comprehensive review of studies comparing the outcomes of various treatment modalities.

Peripheral artery disease (PAD) is a common vascular condition affecting over 200 million people worldwide. It is primarily characterized by stenosis or occlusion of peripheral arteries due to atherosclerosis. The infrainguinal segment is frequently involved in PAD, making revascularization decisions for infrainguinal arterial disease (IAD) complex. Multiple factors, including the patient’s condition and anatomical characteristics, must be carefully considered when determining the optimal treatment approach. Once these factors are evaluated, the first revascularization strategy is selected from among open, endovascular, or hybrid modalities, based on high-level evidence. Endovascular therapy is widely accepted as the standard treatment for simple IAD, with balloon angioplasty and stenting being the commonly used techniques.However, advancements in endovascular techniques have enabled the treatment of increasingly complex lesions. Additionally, drug-based technologies have enhanced the durability of treatment outcomes, including improvements in primary patency rates and freedom from target lesion revascularization. Similar to surgical endarterectomy, percutaneous atherectomy has been developed to remove atherosclerotic plaques and mitigate intimal calcification. The purpose of this paper is to present an algorithm for revascularization of IAD through a comprehensive review of studies comparing the outcomes of various treatment modalities.

Peripheral artery disease (PAD) is a common vascular condition affecting over 200 million people worldwide. It is primarily characterized by stenosis or occlusion of peripheral arteries due to atherosclerosis. The infrainguinal segment is frequently involved in PAD, making revascularization decisions for infrainguinal arterial disease (IAD) complex. Multiple factors, including the patient’s condition and anatomical characteristics, must be carefully considered when determining the optimal treatment approach. Once these factors are evaluated, the first revascularization strategy is selected from among open, endovascular, or hybrid modalities, based on high-level evidence. Endovascular therapy is widely accepted as the standard treatment for simple IAD, with balloon angioplasty and stenting being the commonly used techniques.However, advancements in endovascular techniques have enabled the treatment of increasingly complex lesions. Additionally, drug-based technologies have enhanced the durability of treatment outcomes, including improvements in primary patency rates and freedom from target lesion revascularization. Similar to surgical endarterectomy, percutaneous atherectomy has been developed to remove atherosclerotic plaques and mitigate intimal calcification. The purpose of this paper is to present an algorithm for revascularization of IAD through a comprehensive review of studies comparing the outcomes of various treatment modalities.

Background: Although the concepts of a family physician and regular doctor are interchangeably used in the general population, they differ in various aspects of healthcare services. We investigated the prevalence of having a family physician/regular doctor and its association with healthcare utilization behaviors among community-dwelling adults. Methods: A cross-sectional survey was conducted among students and employees at a university from October 2018 to February 2019. Information was collected on the presence of a family physician/regular doctor, healthcare facilities most frequently visited, annual healthcare visit frequencies, and out-of-pocket medical expenses. Associated factors with having a family physician/regular doctor were analyzed using multivariable logistic regression adjusting for demographic characteristics, health-related variables, and healthcare utilization behaviors. Results: A total of 5,890 individuals were included, of which 15% had family physicians/regular doctors (students 12.6%, employees 21.3%). Factors significantly associated with having a family physician/regular doctor were older age, higher income level, and managing chronic diseases.Individuals having a family physician/regular doctor were more likely to use large/tertiary hospitals rather than primary care clinics, use healthcare services more frequently, and have higher medical expenditures. Conclusion The prevalence of having a regular doctor was low in community-dwelling adults, with a higher prevalence among high-income groups and a tendency to visit large/tertiary hospital specialists for a regular doctor. Our results indicate that many community-dwelling individuals lack proper awareness of the roles of family physicians in providing comprehensive and continuous healthcare, emphasizing urgent needs to enhance public awareness of the concept of family physicians based on primary care.

Background: Although the concepts of a family physician and regular doctor are interchangeably used in the general population, they differ in various aspects of healthcare services. We investigated the prevalence of having a family physician/regular doctor and its association with healthcare utilization behaviors among community-dwelling adults. Methods: A cross-sectional survey was conducted among students and employees at a university from October 2018 to February 2019. Information was collected on the presence of a family physician/regular doctor, healthcare facilities most frequently visited, annual healthcare visit frequencies, and out-of-pocket medical expenses. Associated factors with having a family physician/regular doctor were analyzed using multivariable logistic regression adjusting for demographic characteristics, health-related variables, and healthcare utilization behaviors. Results: A total of 5,890 individuals were included, of which 15% had family physicians/regular doctors (students 12.6%, employees 21.3%). Factors significantly associated with having a family physician/regular doctor were older age, higher income level, and managing chronic diseases.Individuals having a family physician/regular doctor were more likely to use large/tertiary hospitals rather than primary care clinics, use healthcare services more frequently, and have higher medical expenditures. Conclusion The prevalence of having a regular doctor was low in community-dwelling adults, with a higher prevalence among high-income groups and a tendency to visit large/tertiary hospital specialists for a regular doctor. Our results indicate that many community-dwelling individuals lack proper awareness of the roles of family physicians in providing comprehensive and continuous healthcare, emphasizing urgent needs to enhance public awareness of the concept of family physicians based on primary care.

Background: Although the concepts of a family physician and regular doctor are interchangeably used in the general population, they differ in various aspects of healthcare services. We investigated the prevalence of having a family physician/regular doctor and its association with healthcare utilization behaviors among community-dwelling adults. Methods: A cross-sectional survey was conducted among students and employees at a university from October 2018 to February 2019. Information was collected on the presence of a family physician/regular doctor, healthcare facilities most frequently visited, annual healthcare visit frequencies, and out-of-pocket medical expenses. Associated factors with having a family physician/regular doctor were analyzed using multivariable logistic regression adjusting for demographic characteristics, health-related variables, and healthcare utilization behaviors. Results: A total of 5,890 individuals were included, of which 15% had family physicians/regular doctors (students 12.6%, employees 21.3%). Factors significantly associated with having a family physician/regular doctor were older age, higher income level, and managing chronic diseases.Individuals having a family physician/regular doctor were more likely to use large/tertiary hospitals rather than primary care clinics, use healthcare services more frequently, and have higher medical expenditures. Conclusion The prevalence of having a regular doctor was low in community-dwelling adults, with a higher prevalence among high-income groups and a tendency to visit large/tertiary hospital specialists for a regular doctor. Our results indicate that many community-dwelling individuals lack proper awareness of the roles of family physicians in providing comprehensive and continuous healthcare, emphasizing urgent needs to enhance public awareness of the concept of family physicians based on primary care.

Background: Although the concepts of a family physician and regular doctor are interchangeably used in the general population, they differ in various aspects of healthcare services. We investigated the prevalence of having a family physician/regular doctor and its association with healthcare utilization behaviors among community-dwelling adults. Methods: A cross-sectional survey was conducted among students and employees at a university from October 2018 to February 2019. Information was collected on the presence of a family physician/regular doctor, healthcare facilities most frequently visited, annual healthcare visit frequencies, and out-of-pocket medical expenses. Associated factors with having a family physician/regular doctor were analyzed using multivariable logistic regression adjusting for demographic characteristics, health-related variables, and healthcare utilization behaviors. Results: A total of 5,890 individuals were included, of which 15% had family physicians/regular doctors (students 12.6%, employees 21.3%). Factors significantly associated with having a family physician/regular doctor were older age, higher income level, and managing chronic diseases.Individuals having a family physician/regular doctor were more likely to use large/tertiary hospitals rather than primary care clinics, use healthcare services more frequently, and have higher medical expenditures. Conclusion The prevalence of having a regular doctor was low in community-dwelling adults, with a higher prevalence among high-income groups and a tendency to visit large/tertiary hospital specialists for a regular doctor. Our results indicate that many community-dwelling individuals lack proper awareness of the roles of family physicians in providing comprehensive and continuous healthcare, emphasizing urgent needs to enhance public awareness of the concept of family physicians based on primary care.

Endovascular treatment is an acceptable option for patients with aortoiliac occlusive disease. However, bilateral passage of guidewires through the aortoiliac occlusion can be a challenging step in achieving successful revascularization. The aim of this article is to present a novel strategy for successfully passing bilateral guidewires through long aortoiliac occlusive lesions. After one guidewire is passed through the aortic and iliac lesions via one side of the femoral artery, the other guidewire is passed using the up-and-over technique and pulled out from the ipsilateral side of the body. This contralateral guidewire is then inserted into the ipsilateral angiographic catheter along with the ipsilateral guidewire. Subsequently, the angiographic catheter is removed in a manner similar to a peel-away sheath. Eventually, bilateral guidewires can be passed through the lesion via a single aortic tract.