Below the knee atherectomy is a hot topic right now in the vascular community. Why is it so controversial? Dr. Anahita Dua, vascular surgeon at Mass General, joins host Dr. Sabeen Dhand to explore the utility of this technique and the pressing need for more Level I evidence in this space.

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This podcast is supported by:
AngioDynamics
https://www.auryon-system.com/

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SYNPOSIS

The conversation dives into the controversial role of below-the-knee atherectomy in limb salvage, an area where data has long been debated. Dr. Dua, principal investigator of the AMBITION BTK Trial—the first randomized controlled trial comparing below-the-knee atherectomy to angioplasty alone—introduces the trial and explains how it fits into the current body of literature.

Together, the doctors review past evidence, current practice, and the future outlook for tibial interventions. Dr. Dua outlines the wide range of techniques and clinical strategies used to manage PAD, and stresses the importance of physician engagement with the NIH and research community to establish stronger, evidence-based protocols. She also shares her candid thoughts on the most overrated and underrated devices in tibial intervention, highlighting atherectomy’s potential role in vessel preparation before below-the-knee treatment.

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TIMESTAMPS

00:00 - Introduction
04:55 - Current State of Evidence and Challenges
10:54 - Heterogeneity in PAD Treatment
14:26 - Need for National Metrics and Standardization
20:51 - AMBITION BTK Trial and Importance
27:23 - Potential Outcomes and Implications
30:18 - Trial Design
34:56 - Advice for Practitioners
37:36 - Underrated and Overrated Devices
41:50 - Conclusion

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RESOURCES

AMBITION BTK Trial:
https://www.angiodynamics.com/studies/ambition-btk/