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BackTable Vascular & Interventional
Ep. 408 Laser BTK Study Insights: Navigating Complex Lesions with Dr. Nicolas Shammas
Jan 23, 2024
Dr. Sameh Sayfo and Dr. Nicolas Shammas discuss critical limb ischemia (CLI) and the use of lasers in below-the-knee (BTK) treatment. They explain the challenges of treating infrapopliteal disease and the efficacy of laser atherectomy for calcified lesions. The ongoing multicenter study on the Auryon laser atherectomy system in CLI patients is reviewed, along with advice on building a strong CLI program.
40:39
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Quick takeaways
- Laser atherectomy has become an important modality in vessel prepping for below-the-knee (BTK) interventions due to its efficacy in treating fibro-calcific and calcific lesions.
- Building a successful CLI program requires a collaborative, multi-disciplinary approach involving endovascular specialists, vascular surgeons, wound specialists, administrative support, and comprehensive patient care beyond revascularization.
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Overview of the podcast episode
In this episode of the VACTIM podcast, Dr. Nicholas Shamos discusses the status of laser atherectomy in the treatment of below-the-knee (BTK) chronic limb ischemia (CLI) disease. He highlights the challenges and limitations of current treatments for infrapopliteal disease, such as balloon angioplasty, and explores why laser atherectomy has become an important modality in vessel prepping for BTK interventions. Dr. Shamos provides insights into the physical properties of the laser device, specifically the Orion laser from AngioDynamics, and how it offers advantages in treating fibro-calcific and calcific lesions. He shares the positive results and safety outcomes of the ongoing Aryan below-the-knee study, emphasizing the importance of long-term follow-up to evaluate limb salvage and primary patency. Dr. Shamos also discusses the need for a collaborative, multi-disciplinary approach in building a successful CLI program, including the involvement of endovascular specialists, vascular surgeons, wound specialists, and other key members. He highlights the importance of administrative buy-in and resource allocation to support the program, and emphasizes the significance of comprehensive patient care beyond revascularization, including pharmacologic management and lifestyle interventions for cardiovascular risk reduction.
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