From head to toe: the expanding reach of endovascular therapy

By Rodrigo Silva, Global Product Manager, Zeus.

There’s no doubt endovascular therapy has revolutionized the treatment of cardiovascular complications. What once required invasive surgery can now be treated by working through blood vessels inside the body, using specialist devices created for this work.

Such minimally invasive medical techniques have become a rapidly developing area of vascular surgery globally. According to the Vascular Society for Great Britain and Ireland, demand is set to rise 67% by 2029.

Endovascular treatment provides benefits for both the medical sector, and the patient. Due to less severe surgery, hospital stays are shorter, which means less resources have to be allocated to each patient. For the patient, recovery time is generally faster and less painful, due to less stress on the heart and smaller incisions to heal. Meanwhile, and most importantly, research suggests long term survival outcomes are better.

The challenge beyond the heart
Until fairly recently, endovascular treatment mainly focused on treating those at risk of heart attacks and other cardiovascular conditions such as aneurysms and thoracic aortic diseases. Veins and arteries are larger in this area of the body – it’s easier to precisely navigate a catheter to where a stent is required.

The challenge grows when we consider other parts of the body, such as the feet, to treat peripheral arterial disease (it is estimated that over 200 million people worldwide suffer from this condition), or the brain, to prevent or treat stroke.

Blood vessels in the foot are much smaller and notoriously difficult to navigate. It’s not always a straight access and calcification can be worse in these more restricted parts of the body. The same challenges exist when accessing the brain.

Even with these challenges, research has shown that endovascular intervention in these areas have highly successful outcomes:

  • The well-documented MR CLEAN trial, carried out by the Multicenter Randomized Clinical Trial of Endovascular Treated for Acute Ischemic Stroke in the Netherlands, demonstrated the positive long-term effects of endovascular treatment. The trial assessed functional recovery outcomes for a number of stroke patients split into a control group and an endovascular intervention group. Patient outcomes were measured using the Modified Rankin Scale for Neurologic Disability (mRS)*. Results showed a significant difference in outcome between the two groups, with the intervention group demonstrating a better functional recovery at 90 days, as measured by the mRS. The trial also documented that these positive effects still persisted two years later.
  • Another analysis by the CRITISCH Registry (Registry of First-Line Treatments in Patients With Critical Limb Ischemia) studied the most effective first-line treatment for patients with critical limb ischemia in terms of amputation-free survival. One group of patients received endovascular therapy, with the other group undergoing bypass surgery. The selection of treatment type was left to the discretion of the physician and the group of patients who underwent endovascular therapy were higher risk patients as a result of being older and more ill. One-year on, amputation-free survival for group who received endovascular intervention was 75%, compared to 72% for the bypass surgery group, despite the fact the endovascular group were higher risk patients.

These endovascular interventions are only becoming possible with the development of highly innovative and intricate microcatheters. Devices must be incredibly tiny and nimble to accurately traverse these miniscule areas of the body, safely and effectively.

With this in mind, I’m sure you’ll wholeheartedly agree that the need for catheter innovation to keep pace is clear. Catheters must combine a multitude of properties and functions to serve the increased and wider use of endovascular treatment. They must be incredibly strong and flexible, whilst tiny enough to safely access the far reaches of the body, such as below the knee and above the neck. It’s no small feat!

Minuscule catheter liners with superior strength and flexibility
Many of our customers are at the forefront of catheter design and manufacture. It was clear they needed our help where intricate catheter liners were concerned. And so, we worked with them to create the PTFE StreamLiner™ series. 

Essentially, StreamLiner™ catheter liners enable device engineers to build microcatheters which can safely reach more parts of the body – even via the smallest vasculatures and the most complex anatomies.

The StreamLiner™ series enables new limb and life-saving therapies to become possible. Endovascular treatment will accelerate with access to the right tools. 

Clinicians enjoy huge benefits from catheters built with such tiny catheter liners:

  • Access minuscule vasculatures – they’re extremely thin
  • Travel far and deep inside the body – they’re incredibly strong
  • Safely navigate tortuous twists and turns – they’re very flexible

Not only are StreamLiner™ liners stronger, they offer greater pushability whilst remaining kink resistant.

I’m incredibly proud to say that customer feedback about StreamLiner™ liners has been incredibly positive. The next generation of microcatheters is now a reality – it’s a game-changing development.

StreamLiner™ liners are helping to keep our customers at the forefront of catheter design. It’s an incredible advantage that provides meaningful benefits to medical teams and society as a whole.

Stories of innovation & StreamLiner™ use cases
Read our stories of innovation to further understand how StreamLiner™ is supporting endovascular treatment in the far reaches of the body:

Endovascular Interventions: Below-the-knee
Treatment for PAD patients who fail conservative management has traditionally been surgical revascularization. However, there is increasing evidence to support endovascular intervention in patients where in-line flow to the foot can be re-established. Despite advances, routine below-the-knee peripheral vascular intervention is limited as a result of a lack of interventional devices of appropriate length, strength, thickness, diameter, and flexibility.

Endovascular Interventions: The brain
The brain, with its tiny blood vessels and highly tortuous arteries, presents a unique challenge for catheter engineers: designing a catheter with the right combination of properties which can more easily access and navigate the vasculature of the brain, without sacrificing torque, pushability, and trackability – to open up new pathways and delivering life- saving treatments.

Order your StreamLiner™ samples
Should you want to see our catheter liners for yourself, please contact us here and we’ll arrange some free samples for you.

As a partner to medical device OEMs globally, we’re here to help and would love to discuss any projects you’re working on.

*The Modified Rankin Scale for Neurologic Disability measures the degree of disability or dependence in the daily activities of people who have suffered a stroke.