Ep. 364 Percutaneous Transmural Arterial Bypass (PTAB) as a Treatment Option for CTOs with Dr. Sean Lyden

In this episode, host Dr. Sabeen Dhand interviews vascular surgeon Dr. Sean Lyden about percutaneous transarterial bypass (PTAB) with DETOUR, a new therapy for treating occlusive / stenotic superficial femoral artery (SFA) disease.

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SHOW NOTES

Dr. Sean Lyden serves as the Chairman of Vascular Surgery at Cleveland Clinic. Sean starts off the discussion by conveying the severity of SFA chronic total occlusion (CTO) and walks us through what PTAB therapy is. We then cover the steps and general principles of using the DETOUR technology.

Throughout the episode, Sean and Sabeen discuss the structure and key takeaways of both the DETOUR 1 and DETOUR 2 trials, held in Europe and the United States respectively. They also cover major questions, such as DVT and PE risk, patency of femoral vein following DETOUR intervention, and overall device cost.

We conclude the episode with future directions of the now FDA-approved DETOUR device, and when and how vascular and interventional physicians can incorporate the new technology into their practice. Sean and Sabeen also contrast prior treatment options with the recent DETOUR trials to highlight how longer calcified / occluded SFA lesions now have a viable, effective, and safe endovascular treatment option.

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RESOURCES

PTAB with DETOUR System:

https://endologix.com/ptab/detour/

DETOUR 1 Trial:

https://pubmed.ncbi.nlm.nih.gov/29327570/

DETOUR 1 Trial, 1 year follow-up results:

https://pubmed.ncbi.nlm.nih.gov/32276015/

DETOUR 2 Trial, 12 month results:

https://www.jvascsurg.org/article/S0741-5214(22)01274-5/fulltext

DETOUR 2 Trial, 24 month results from Vascular Annual Conference Presentation:

https://www.dicardiology.com/content/endologix-announces-24-month-results-detour-2-study-2023-vascular-annual-meeting

Voyager Trial:

https://www.nejm.org/doi/full/10.1056/nejmoa2000052

Compass Trial:

https://www.nejm.org/doi/full/10.1056/nejmoa1709118