Understanding DETOUR System

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Peripheral artery disease (PAD) is a common yet serious condition that affects blood flow to the lower extremities. It occurs when fatty plaque builds up in the peripheral arteries, narrowing or blocking them and preventing adequate circulation to the legs and feet. Without proper blood flow, these areas may experience pain, weakness and, in severe cases, nonhealing wounds that could lead to limb loss.

The primary cause of PAD is atherosclerosis, a condition in which cholesterol, fat, calcium and other substances accumulate along the artery walls. Over time, this buildup restricts blood flow and increases the risk of complications such as stroke, heart attack and critical limb ischemia. Certain risk factors, including aging, smoking, diabetes, high blood pressure and high cholesterol, can increase the likelihood of developing PAD.

Symptoms of PAD often include pain, cramping or heaviness in the legs when walking that subsides with rest, also known as intermittent claudication. Other signs may include leg numbness, cold feet, slow-healing sores and changes in skin color or hair growth. Because PAD symptoms can be mistaken for different conditions, such as arthritis, many individuals remain undiagnosed and at risk for further complications.

For those with severe PAD who cannot undergo traditional surgery, the DETOUR System offers a minimally invasive alternative to help improve circulation, manage symptoms and enhance quality of life.

What Is the DETOUR System?

The DETOUR System is a minimally invasive bypass surgery designed to restore blood flow in patients with peripheral artery disease who have narrowed or blocked arteries in the superficial femoral and popliteal arteries, which supply blood to the knee and lower leg. The DETOUR System consists of three key components:

A small, spiral stent made of metal (nitinol) enclosed in a polymer (ePTFE)
A delivery catheter
A crossing tool that helps guide the delivery catheter and covered stent to the correct position

The percutaneous transmural arterial bypass (PTAB) technique used in the DETOUR System has demonstrated excellent results in treating femoropopliteal occlusive disease. This condition occurs when the arteries in the thigh and knee (femoropopliteal segment) become narrowed or blocked, reducing blood flow to the lower leg and foot. The technique creates a new pathway around the blocked artery, ensuring continuous blood flow.

How Does the DETOUR System Work?

The DETOUR procedure follows the following steps:

Insertion of the Crossing Tool. A small incision is made in the groin, and a crossing tool is inserted into a blood vessel. The tool is guided through the vessel until it reaches the narrowed or blocked section of the artery.
Creating a New Pathway. The tool advances a needle and wire into a nearby vein above the blockage. This process is repeated from below the blockage, allowing the guidewire to extend from the artery, through the vein and back into the artery below the narrowed section.
Placement of the Covered Stent. A delivery catheter is used to pass the covered stent from the artery above the blockage, through the nearby vein, and then back into the artery below the blockage.
Stent Expansion. Once in position, the covered stent is released and expands, forming a stable tube that allows blood to flow around the blockage. Additional stents may be placed if needed to extend coverage of the blocked artery.
Completion of the Procedure. The delivery catheter is removed, and the covered stent remains permanently implanted within the artery and vein. This new pathway restores proper circulation to the lower leg, relieving symptoms and improving mobility.

What Are the Key Benefits Of the DETOUR System for Patients?

By utilizing percutaneous arterial bypass technology, the DETOUR System helps restore blood flow to the lower extremities, reducing symptoms and improving mobility for individuals with chronic limb ischemia or long-segment artery occlusion. Early results suggest that appropriately selected patients with long-segment occlusive disease above the knee can be safely treated using the DETOUR System for percutaneous bypass, with improved patient outcomes extending to two years.

Who Is a Candidate For the DETOUR System?

The DETOUR System is intended for individuals with peripheral artery disease who have superficial femoral artery blockage or femoropopliteal occlusive disease and are not candidates for traditional surgical repair. This includes patients with:

Narrowing or blockage in the superficial femoral and popliteal arteries
Limited treatment options due to other health conditions preventing surgical intervention

However, the DETOUR System is not suitable for individuals with:

A distal common femoral artery that is too narrow (<7 mm in diameter)
A high risk of developing deep vein thrombosis
Blocked arteries above or below the femoropopliteal arteries
Bleeding disorders or an inability to take anticoagulants
Allergies or sensitivities to nitinol, PTFE, aspirin or heparin

By providing a minimally invasive alternative, the DETOUR System can be considered for patients seeking treatments for PAD when surgery is not an option.

Are There Any Risks Associated With the DETOUR System?

The DETOUR System, as does any peripheral artery disease treatment, carries potential risks. While the procedure is minimally invasive, complications such as stent migration, infection or vessel narrowing may occur in some cases. Additionally, patients must be evaluated for their ability to take blood-thinning medications to prevent clotting after the procedure.

However, the DETOUR System for leg arteries has been developed to offer a safe and effective alternative for individuals who need long-segment artery occlusion treatment but are not candidates for open bypass surgery. Consulting a cardiologist can help determine if this option is right for you.

Find a PAD Doctor in San Antonio

HealthCare is Better Together.

When it comes to cardiovascular care, we understand that heart and vascular issues require experienced medical intervention and compassion. Our multidisciplinary approach at Baptist Medical Center and Northeast Baptist Hospital includes coordinating cardiologists, vascular surgeons and other healthcare professionals who are dedicated to helping ensure comprehensive care and optimal cardiac health outcomes.

Our cardiac and vascular services can help whether you need emergency cardiac care, a vascular procedure or ongoing preventive care. Let us help you stay on top of your heart health with our multidisciplinary cardiovascular care. Call us at 866-309-2873 or learn more about our comprehensive cardiovascular services and locations here.