He characterized them as similar to the ability to combine devices with drugs, which he called the biggest transformational change leading to current standard-of-care treatment for peripheral vascular conditions.
“That has completely changed the face of vascular care from an endovascular standpoint,” Jaff said in an interview. “Prior to that, in all the trials that were done the results were really not great for long-term durability for patients. And so that’s why surgical approaches remained very much frontline, because they had much better results than early-stage catheter-based interventions. All of a sudden, you completely changed that field when you add a drug to a device that provides the same ability to open the artery, but keep it open longer and make it competitive with surgical approaches.”Similar to the ability to combine drugs and devices, Jaff singled out advances in catheter technology to reach and treat clots.
For example, patients with peripheral pulmonary embolism (PE), a common problem, are most often treated with blood thinners. But over the past decade or so, technology has advanced with catheter-based devices that dissolve or remove the clots.
“That’s gained a lot of enthusiasm,” he said. “It’s been a technological advancement that’s outpaced the science. And so collecting the evidence to show that that’s actually better in certain patients than standard-of-care anticoagulation is what still needs to happen.”
Those trials are ongoing, including Boston Scientific’s HI-PEITHO trial for its EkoSonic Endovascular System (EKOS). EKOS uses ultrasound energy combined with a thrombolytic drug to dissolve clots in patients with PE and peripheral artery blockages.