RODEO-PTAB Evaluates Single-Vessel Runoff in SFA Disease Treated With Endologix Detour System

April 28, 2026—Recent findings from a substudy of DETOUR2 demonstrated that percutaneous transmural arterial bypass (PTAB) may offer an alternative to leg bypass surgery for patients with complex peripheral arterial disease, even when distal vessel run off is severely limited.

The substudy, called RODEO-PTAB, evaluated runoff determinants of endovascular outcomes after PTAB in patients with single vessel outflow. The findings were presented as late-breaking data at the Society of Cardiovascular Angiography & Interventions (SCAI) 2026 scientific sessions.

According to the SCAI press release, PTAB with the Detour system (Endologix) is a novel alternative to treating long complex superficial artery (SFA) disease by placing stents through the femoral vein to create a new pathway for blood to bypass the diseased artery and improve circulation in the leg. This single-vessel outflow increases the risk of complications, noted SCAI.

As stated by SCAI, the results from the prospective, single-arm, multicenter DETOUR2 study showed excellent patency for PTAB through 3 years, but the impact of single-vessel runoff on outcomes was previously unknown.

RODEO-PTAB utilized 3-year data from the DETOUR2 study (presented in November 2024) to determine whether single-vessel outflow affects clinical outcomes.

The press release reported that of the 200 patients who underwent PTAB at 32 sites, 191 had evaluable distal runoff for core laboratory analysis. Among these patients, 33 had single-vessel runoff, and 158 had more than one vessel runoff.

SCAI further noted that a logistic regression model was used to determine the role of distal runoff while accounting for other factors that may influence results, including vessel characteristics and patient medical history. Multivariable models were constructed with and without runoff included as a predictor to assess its independent impact on outcomes.

As summarized by SCAI, the RODEO-PTAB investigators found the following:

• The primary patency at 1, 2, and 3 years was similar for patients with one vessel runoff (79.6%, 64.1%, and 54.2%) compared to patients with more than one vessel runoff (83.2%, 68.7%, and 58.5%) (P = .4353).
• Freedom from clinically driven target lesion revascularization for single-vessel runoff was 63.1% through 3 years versus 67.2% for those with more than one vessel runoff (P = .4495).
• The proportion of patients without major adverse limb events was 62.4% for one vessel runoff, compared to 65.4% for those with more than one vessel through 3 years.
• Logistic regression analysis demonstrated that the number of runoff vessels was not significant predictor for these clinical outcomes.

“Findings from this study show that patients with single-vessel runoff maintained excellen patency through 3 years and can safely benefit from this minimally invasive treatment,” commented Sameh Sayfo, MD, in the SCAI press release. “These results give operators greater confidence to adopt this technology and treat complex patients who might otherwise be referred for open surgical bypass or have limited treatment options.”