Pathway's Jetstream G2 up close and personal

I attended a single day conference focusing on atherectomy and the use of the Jetstream G2 atherectomy/thrombectomy device from Pathway Medical. I've posted quite a bit about the atherectomy space in vascular therapy. That's because, I think that it represents a critical phase of technology innovation in the treatment of infrainguinal PAD   Currently, all the available therapies are plagued by differing failure modes. Angioplasty, stenting and atherectomy have various mechanisms of failure at different intervals. And different therapies may selectively benefit various disease types. SFA disease represents a large challenge with various options for treatment. see sfa challenge   The Jetstream G2 represents the second generation of the Pathway device. It now has a thrombectomy indication which makes it quite appealing. In the demonstrations of the device, it performed remarkably well in the treatment of CTO's of the SFA. There is an emerging body of treatment philosophy that traversing CTOs intraluminally as opposed to subintimally will provide the best opportunity to utilize future technology such as drug eluting balloons and stents. With this in mind, the Jetstream was used in combination with the Crosser device (FlowCardia Inc., Sunnyvale, CA) which allows central crossing of the lesion.   In most cases, IVUS verified a concentric crossing of the total occlusion with a luminal size of 2.7-3.5 mm. The primary treatment with the Jetstream was complimented by low pressure balloon angioplasty.   The technology seemed to work very well in In Stent restenosis which has a very high recurrency rate with limited effective treatment modalities currently. Additionally, it proved highly effective at penetrating fibrocalcific plaque formation.   Treatement times were somewhat prolonged depending on the plaque mophology.   The advantages of the Jetstream over the diamondback from CSI appear to be the ability to treat longer lesions at one setting in less time with the same device. The Jetstream sizes from 2.1 up to provide flexibility and cost savings from using only a single catheter per treatment   Additional data will be forthcoming, however, I was pleasantly surprised at the results seen in the live demo cases