Vascular Disease Prospective-Retrospective Observational Registry for Aortic Aneurysm and Peripheral Artery Disease in Korea: Study Rationale and Methodology.

Abstract

Purpose: Peripheral artery disease (PAD) and aortic aneurysm (AA) are major manifestations of systemic atherosclerosis. Although they differ in pathophysiology and clinical presentation, they share common risk factors and overlapping biological pathways. However, long-term integrated data encompassing both conditions remain limited in Korea, constraining real-world evidence generation and outcome evaluation.

Materials and methods: To address this gap, the Vascular disease Prospective-Retrospective Observational Registry (VAPOR) was established as a mixed retrospective- prospective registry. VAPOR was initially implemented at a single coordinating center and was designed for stepwise expansion to multiple institutions. The registry systematically collects clinical, imaging, and procedural data from patients with AA and PAD. It aims to identify shared and disease-specific risk factors, evaluate outcomes, and apply established risk-stratification frameworks, thereby supporting the development of an interoperable vascular data infrastructure for precision medicine, quality benchmarking, and policy development.

Results: As of April 15, 2026, VAPOR included 5,249 unique patients, comprising 4,438 patients in the retrospective cohort and 811 patients in the prospective cohort. The registry included 2,193 patients with AA and 3,287 patients with PAD; 231 patients had both AA and PAD. The primary outcomes are the incidence of major adverse cardiovascular events, major adverse limb events, and aneurysm- or procedure-related adverse events. Secondary outcomes include technical success, hemodynamic and imaging parameters, safety outcomes, and patient-centered endpoints.

Conclusion: VAPOR provides a comprehensive real-world dataset for evaluating treatment outcomes and long-term prognoses in patients with AA or PAD. By integrating retrospective and prospective cohorts and establishing an infrastructure for multicenter expansion, VAPOR represents an important initiative in Korean vascular surgery and has the potential to enhance evidence-based management and advance precision vascular care.