1518_Soukas.pdf

1、Endovascular intervention and advent of PTAB make PTFE bypass obsoletePeter A.Soukas,MD,FACC,FSVM,FSCAI,FACP,RPVIDirector,Vascular Medicine&Interventional PV LabDirector,Brown Vascular&Endovascular Medicine Fellowship The Miriam&RI Hospitals,Providence,RIAssociate Professor of MedicineBrown Medical

2、SchoolDisclosures Institutional Grant/Research Support:AcoArt,Akura,AngioSafe,AVS,BD,BSC,Cagent Vascular,Cordis,Contego Medical,Endologix,Medtronic,Penumbra,r3Vascular,Reva Medical,Shockwave Medical,W.L.Gore Consultant:Abbott,BSC,Cagent Vascular,Contego Medical,Endologix,Medtronic,Shockwave Medical,

3、W.L.Gore Advisory Board:Abbott,AngioSafe,BSC,Cagent Vascular,Endologix,Medtronic,Shockwave Medical,W.L.GoreOptions for Long and Complex SFA LesionsOptions for Long and Complex SFA Lesions Lower extremity bypass(LEB),i.e.an open surgical procedure,still considered to be the current gold standard for

4、diffuse,long complex femoropopliteal lesions LEB has good limb salvage rates;however,the procedure is hindered by high morbidity(36.8%),higher mortality(2.3%30-day),higher infection rates(4.5-14%),lengthy hospitalization stays(5.7 days),and lengthy recovery periods New technologies have enabled EVT

5、for long-segment and complex SFA lesions but are limited by high rates of restenosis at one year(up to 25%)PTAB(Percutaneous Transmural Arterial Bypass)with the DETOUR System is a technique for femoropopliteal bypass to avoid the limitations and complications of traditional open bypass surgeryDETOUR

6、 Procedure for Percutaneous FemDETOUR Procedure for Percutaneous Fem-Pop Bypass Pop Bypass Originates in SFA,travels within the femoral vein,and returns to the popliteal artery Surgical principles using an endovascular approachFemoral vein becomes pathway for stent graft bypassCrossing DeviceTORUSSt