In a podium-first presentation at the 2026 Charing Cross (CX) Symposium (21–23 April, London, UK), Dainis Krievins (Riga, Latvia) shared five-year results from one of the centres participating in the DETOUR I and II trials of the Detour system (Endologix) for percutaneous femoropopliteal bypass, including a 100% technical success rate.
Opening his presentation, Krievins described the Detour procedure as one that involves surgical principles used via an endovascular approach. He continued that the procedure originates in the superficial femoral artery (SFA), travels within the femoral vein, and then returns to the popliteal artery. Essentially, he summarised, “the femoral vein becomes the pathway for stent-graft bypass”.
The presenter highlighted the global nature of the DETOUR trials by pointing to sites in Latvia, Germany, Poland, the USA, New Zealand and Chile, going on to specify that he would be sharing five-year results from his site in Riga at the CX 2026 podium.
In terms of baseline demographics of the patients enrolled at the Riga site, Krievins noted a mean age of 63±7 years and that 94% of patients (49/52) were male.
Regarding baseline lesion characteristics, Krievins highlighted a mean lesion length in 54 legs studied of 28.4±8.6cm and the fact that 67% (36/54) had severe calcification, with a further 17% (9/54) having moderate calcification.
Moving on to the data, Krievins reported a primary patency rate of 37% at five years, comparing this to rates of 80%, 57.4% and 41.3% at one, two and three years, respectively.
Turning his attention to primary assisted patency, the presenter reported a rate of 57.4% at five years, as compared to 88.9%, 77.8% and 60.9% at one, two and three years, respectively.
Furthermore, Krievins shared a five-year second patency rate of 63%, down from 92.6%, 85.2% and 69.6% at one, two and three years, respectively.
With regard to safety outcomes, Krievins noted one instance of symptomatic deep vein thrombosis at the one-month follow-up mark before emphasising there were no significant changes in venous symptom scores or physiologic function.
On functional improvement, the presenter shared that 76% of patients experienced Rutherford improvement of one or more classes.
Concluding, Krievins stated that a 100% technical success rate at the Riga site “demonstrates an intuitive procedure that can be easily adopted across the most challenging lesions” and that safety outcomes “demonstrate percutaneous bypass has a promising safety profile”.
Furthermore, the presenter reiterated that there was no significant impact on venous health and emphasised “acceptable” durability in long, challenging, calcified occlusive lesions.
Based on these findings, Krievins remarked that fully percutaneous bypass is a “promising endovascular alternative for complicated and complex femoropopliteal disease”. He pointed to forthcoming long-term results from other sites and commented that patient selection for Detour bypass needs to be determined.
On a more general note, Krievins ended his presentation by stressing that “there is still a need for open bypass surgery”.
