Vascular surgeon Dr. Justin Daddario and his vascular team at the University of Connecticut John Dempsey Hospital are at the forefront of innovative new limb-sparing techniques for severe and complex peripheral artery disease (PAD).
On January 25th, D'Addario performed the first replacement surgery in New England using DETOUR technology. Then in May, he made history again by becoming the first in Connecticut to use the Esprit Esprit™ BTK Everolimus-Eluting Absorbable Scaffold System, an FDA-approved drug-eluting absorbable scaffold. Additionally, he was the first to use Esprit BTK in conjunction with DETOUR, combining these two cutting-edge products to improve limb salvage outcomes.
The Esprit™ BTK Everolimus-Eluting Absorbable Scaffold System (Esprit™ BTK System) offers a new option for patients with severe PAD of below-the-knee arteries.
D'Addario recently treated an 86-year-old PAD patient who was in critical condition because the wound on his foot was not healing and he was experiencing severe pain in his leg and foot. There was a 20-40% risk of losing his leg, and the patient already had a prosthetic on his other leg due to a previous amputation. The innovative treatment employed by D'Addario and his team was crucial in addressing this serious condition and improving the patient's quality of life.
Chronic leg ischemia is a severe form of PAD in which arteries become clogged with plaque, preventing blood flow and oxygen from reaching the legs and feet. As a result, patients with this disease experience extreme pain, open wounds that do not heal, and in some cases amputation. Over a five-year period, the survival rate for this disease is lower than that for breast, colon, and prostate cancer combined.
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Scaffolding system (Esprit™ BTK system)
Providing people with groundbreaking choices
Living with a chronic limb disorder
Below the knee ischemia.
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The Esprit™ BKT System is the first dissolvable stent for patients with chronic below-the-knee ischemia that damages limbs. Approved by the U.S. Food and Drug Administration (FDA) in April, the Esprit™ BTK System is designed to deliver a drug called everolimus to keep the artery open and support the vessel healing before dissolving. The Esprit BTK System is composed of a material similar to dissolvable sutures. Once the blockage is open, the device is implanted in a catheter-based, minimally invasive procedure, and the scaffold helps the vessel heal and provides support until the vessel is strong enough to stay open on its own.
New technologies are revolutionizing the way we treat patients with severe PAD. This combination of advanced technology and complementary systems gives patients treatment options that deliver better outcomes than standard care and a less invasive alternative to surgery. This combined approach is especially valuable for patients who are not suitable for open surgery, allowing them access to effective, innovative treatments.
“As an academic medical center, UConn Health is uniquely positioned to rapidly adopt and implement advanced treatment options, and we are pleased to be able to offer a minimally invasive solution to patients with severe and complex peripheral artery disease,” said D'Addario. “Our innovative approach has already demonstrated success and positive outcomes, and we look forward to leveraging these cutting-edge technologies to continue to make a significant impact on patient care.”
While the Esprit™ BTK System is typically used as a standalone treatment, D'Addario's goal for this high-risk patient was to exhaust all possible options to save the limb. For this reason, he decided to combine Esprit™ BTK with DETOUR Technology. D'Addario believes this integrated approach will set a new standard of care in the coming years, delivering superior outcomes for patients facing complex cases.
Endologix's DETOUR System received breakthrough device designation from the FDA in 2020 and was approved by the FDA in June 2023. Abbott's Esprit™ BTK Everolimus-Eluting Resorbable Scaffold System (Esprit™ BTK System) received breakthrough device designation from the U.S. FDA in 2017 and was approved by the U.S. Food and Drug Administration (FDA) in April.
“FDA approval of the Esprit BTK System is a step forward for below-knee treatment. This new treatment option supports healing while reducing the risk of long-term complications,” said D'Addario. “We are pleased to offer patients the latest technological advances to treat chronic below-knee ischemia, which threatens the limb.”
“The patient's wounds healed within two weeks of surgery, which is quite amazing,” D'Addario said.
UConn Health's Department of Vascular and Endovascular Surgery specializes in innovative treatment of aortic, peripheral artery, carotid, mesenteric and venous disease in patients of all ages. UConn Health surgeons are highly trained in the diagnostic, management, surgical and endovascular techniques to treat these conditions and work closely with primary care providers as well as other specialists in vascular medicine, cardiovascular medicine, radiology, physical medicine and rehabilitation to provide complete care.
