Key result
Percutaneous transmural arterial bypass with Detour risks severe wire entrapment requiring open surgical extraction.
Case Report (n=1)
No
This case highlights a previously unreported failure mode of the Detour endobypass device—irretrievable wire wrap and catheter entrapment—emphasizing the need for operator awareness, careful patient selection, and adaptability during complex endovascular interventions.
Wire wrap risks catheter entrapment with Detour device in complex SFA lesions; hypothesis-generating for technical refinements before broader adoption.
A 75-year-old man with a history of severe ischemic cardiomyopathy, coronary artery disease status post coronary artery bypass graft, stroke, atrial fibrillation, chronic kidney disease, and recent right metatarsophalangeal amputation was admitted for an ischemic nonhealing wound. Angiography demonstrated right superior femoral artery occlusion with above-knee reconstitution. Percutaneous transmural arterial bypass using the Detour device (Endologix, LLC) was complicated by severe wire wrap and irretrievable catheter entrapment, necessitating open extraction and procedure abortion. Despite technical failure, the wound had healed at follow-up. This case highlights device-specific challenges and divergence between technical and clinical success.
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Patel et al. (2026) conducted a case report in Peripheral artery disease with right superior femoral artery occlusion (n=1). Detour endobypass system was evaluated on Technical success / procedure complications. Percutaneous transmural arterial bypass using the Detour device was complicated by severe wire wrap and irretrievable catheter entrapment necessitating open extraction, although the patient's wound ultimately healed.
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