Daniel Torrent: A New Path for ‘No-Option’ Patients – TADV vs Standard of Care in CLTI
Daniel Torrent, Vascular Surgeon at Longstreet Clinic, shared a post on LinkedIn about a recent article by Mounika Naidu Boya et al, published in JVS:
“‘No-option’ CLTI doesn’t have to mean ‘no hope’.
The results of this systematic review and meta-analysis on TADV (Transcatheter Arterialization of Deep Veins) aren’t surprising if you’ve been paying attention to this world. It’s still nice to see it pulled together and peer reviewed.
The most striking stat? Survival. Even though the patients undergoing TADV have similar medical issues to those that don’t, there’s a fairly startling difference in mortality. Saving limbs saves lives.
Interpreting Patency: Patency isn’t on the infographic because there isn’t anything to compare to on the Standard of Care (SoC) cohort which comes from a natural history study. However, generally, primary and primary-assisted patency is less than 50% at six months. Despite this, the limb preservation statistics are wonderful. This procedure works differently than a standard revascularization.
Optimizing for Success: I’ve been impressed with how this procedure has been implemented as well. It wasn’t just thrown out into the market. It’s been a thoughtful rollout with mandatory training and program support. Beyond training on the procedure, I’ve had help on training the ultrasound team for pre-operative and post-operative evaluations. CLTI is a process where the full spectrum of care matters.”
Title: Evidence for transcatheter arterialization of deep veins in poor-option chronic limb-threatening ischemia: A systematic review and meta-analysis
Authors: Mounika Naidu Boya, Isabella Ferlini Cieri, Adriana A. Rodriguez Alvarez, Shiv Patel, Peter A. Schneider, Daniel Clair, Mehdi H. Shishehbor, Anahita Dua
Read the Full Article on Society for Vascular Surgery.
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