St. Luke’s offers incisionless fix for blockages in the leg

St. Luke’s University Health Network has introduced an incisionless way to correct blockages in the superficial femoral artery in the leg.

SLUHN said its Vascular surgeons are first in the area to offer the new procedure that restores blood supply to the leg by bypassing long, chronic total blockages in the main blood vessel of the leg.

Percutaneous transmural arterial bypass, or PTAB, creates a bypass around the diseased artery with a Dacron coated metal stent tube.

This technology takes advantage of the fact that there is usually a large, healthy femoral drainage vein that runs right next to the blocked femoral artery, SLUHN said.

St. Luke’s is the first hospital in the Lehigh Valley and Northeastern Pennsylvania using this minimally invasive procedure, and one of only three programs in the state, said St. Luke’s Chief of Vascular Surgery Dr. Sharvil Sheth.

This limb-saving treatment, called DETOUR by its manufacturer, Endologix, is currently being provided to patients with advanced peripheral artery disease (PAD) who are too high-risk to undergo surgery or have failed prior traditional balloon and stent treatments, he said.

“This minimally invasive procedure has been proven to be a safe and effective treatment, and provides hope to several high-risk patients, who may also suffer from diabetes, kidney and heart disease,” Sheth said. “Restoring blood flow in a leg enhances the patient’s ability to walk painlessly, so they can partake in physical exercise, which helps improve their overall health.”

Unlike traditional methods for treating hardened blocked arteries, including balloon angioplasty and stents which can have a higher rate of failure or bypass surgery requiring multiple large incisions along the leg, in this PTAB technique, a surgeon passes a stent from healthy femoral artery in the groin into the adjacent femoral vein and then re-enters into healthy popliteal artery around the knee.

Steth said it’s like taking a detour in a car, when one of the outbound lanes of the interstate highway is converted to an inbound lane in case of accident or construction, before it rejoins the original inbound lane. In the leg, the outbound lane is usually double the size of the inbound lane and can easily accommodate this extra traffic.

To date, St. Luke’s vascular surgeons have successfully treated three patients in a St. Luke’s hybrid operating room at its Allentown or Bethlehem campus, requiring about 2.5 hours to complete, SLUHN said. Patients are discharged the same day on oral blood thinners.

Peripheral arterial disease is a narrowing or total blockage in the leg that affects about 12 to 19 million Americans, SLUHN said. This condition occurs over time due to various risk factors such as smoking, diabetes, high blood pressure and cholesterol that cause fatty deposits in the wall of the blood vessel.

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