title: National trends for the treatment of peripheral arterial disease in Korea between 2004 and 2013.
abstract: OBJECTIVE
  Peripheral arterial disease (PAD) has been a major public health issue in the elderly. Advances in endovascular surgery have led to a substantial shift in the management of PAD. Although the nationwide trend of PAD treatment in the Western countries was reported, limited data have been available on this in Korea. This study examined the national trend in the treatment of PAD in Korea over the past decade.
  
  
  METHODS
  Health Insurance Review and Assessment Service data were used. We sought to analyze trends in the open and endovascular surgery for the treatment of PAD in Medicare beneficiaries between 2004 and 2013. We also analyzed trends in each types of surgery in the lower extremity. A linear-by-linear association was performed to determine the changes of PAD treatment for this period.
  
  
  RESULTS
  The rate of open surgery per 100,000 Medicare beneficiaries decreased significantly from 8 procedures in 2004 to 6 in 2013. At the same time, endovascular surgery increased from 23 procedures in 2004 to 59 in 2013. Endovascular surgery in the lower extremity increased more than twofold, while the open surgery decreased by 39%. The rate of balloon angioplasty among endovascular surgery was increased by almost threefold, while the bypass surgery using artificial graft decreased by half.
  
  
  CONCLUSIONS
  Endovascular surgery is now performed more commonly than open surgery for PAD treatment. Balloon angioplasty increased by almost threefold, while the bypass surgery using artificial graft decreased by about 50%.
authors.affiliation: Department of Surgery, Graduate School, Kyung Hee University, Seoul, Korea.
authors.forename: Youn Young
authors.initials: YY
authors.lastname: Park
authors.affiliation: Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Jin Hyun
authors.initials: JH
authors.lastname: Joh
authors.affiliation: Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Sang-Ah
authors.initials: SA
authors.lastname: Han
authors.affiliation: Department of Surgery, Graduate School, Kyung Hee University, Seoul, Korea.
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Surgery, Graduate School, Kyung Hee University, Seoul, Korea.
authors.forename: Sungsin
authors.initials: S
authors.lastname: Cho
authors.affiliation: Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Ho-Chul
authors.initials: HC
authors.lastname: Park
authors.affiliation: Department of Surgery, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Ahn
keywords: Balloon angioplasty; Endovascular procedures; Peripheral arterial disease; Trends