This week’s episode features Dr. Anahita Dua, MD, MBA, Associate Professor of Surgery at Massachusetts General Hospital and Harvard Medical School, and Director of the Peripheral Artery Disease Center at MGH. She joins us for a detailed conversation on below-the-knee disease, why recoil after POBA remains a real limitation, and how a retrievable stent platform like Reflow Medical's Spur System is designed to disrupt plaque in a controlled way without leaving a permanent implant. Dr. Dua walks through the clinical rationale behind plaque modification, drug penetration, durability data from early studies through FDA clearance, and how she evaluates outcomes in her own patients through duplex follow-up and wound healing. This episode centers on Dr. Dua’s clinical perspective on tibial interventions and how newer device concepts are influencing real-world decision-making. 03:35 The evolution of complex below-the-knee disease 05:09 Why balloon angioplasty alone often leads to recoil 24:44 FDA endpoints versus clinical durability 25:41 Histologic plaque disruption and controlled microchannels 28:16 Temporary scaffold concept and billing without leaving a stent 30:27 Retrievable stent design and drug penetration strategy 31:34 First-in-human experience and multicenter durability data 33:12 Restenosis and the importance of long-term follow-up 49:51 Duplex stability and wound healing as meaningful outcomes Who Should Listen Vascular surgeons, interventionalists, PAD-focused clinicians, and MedTech leaders who are evaluating durability, restenosis, and how device design translates into real-world outcomes. About Dr. Anahita Dua Dr. Anahita Dua is an Associate Professor of Surgery at Massachusetts General Hospital and Harvard Medical School. She serves as Director of the Peripheral Artery Disease Center, Associate Director of the Wound Center, Clinical Director of Research, and Director of the Sub-Internship in Vascular Surgery. She developed and currently leads the Limb Evaluation and Amputation Program (LEAP) at the MGH. She also founded and runs the only comprehensive vascular surgery homeless clinic in the country at the MGH. Dr. Dua completed her vascular surgery fellowship at Stanford University Hospital, general surgery residency at the Medical College of Wisconsin, and her medical school in the United Kingdom. She has also completed a master's degree (MS) in trauma sciences and a master's in business administration (MBA) in health care management. She also has a certificate in health economics and outcomes research, as well as certificates in drug and device development and Artificial Intelligence (AI) in healthcare from the Massachusetts Institute of Technology (MIT). Dr. Dua is double board-certified in vascular surgery and general surgery. She is also boarded in advanced wound care and management, and has published over 250 peer-reviewed papers and edited five vascular surgery medical textbooks. She runs an NIH-funded lab that focuses on anticoagulation and biomarkers that are predictive of thrombosis and hemostasis in patients who have undergone revascularization. Her research focuses on thromboprophylaxis precision and point-of-care medical approaches to anticoagulation for patients post revascularization. Her clinical and outcomes research focuses primarily on diseases involving peripheral vascular disease, limb salvage, and critical limb ischemia. She is part of a technology development team that creates tools to increase walking distance and wound healing while decreasing pain in patients with peripheral vascular disease. Connect with Dr. Anahita 💼 LinkedIn: Anahita Dua About Reflow Medical Inc. Reflow Medical, Inc. is a privately held medical device company based in San Clemente, California, and a leading developer of innovative medical devices focused on complex cardiovascular disease. A core element of Reflow Medical’s approach is the close collaboration between physicians and engineers, enabling rapid iteration from clinical insight to device design and real-world application. The company’s portfolio includes coronary and peripheral microcatheters, crossing catheters, and the Spur® Stent System, which enables Retrievable Scaffold Therapy (RST), a temporary scaffolding approach designed to modify lesions, reduce recoil, and leave nothing behind. Reflow Medical is committed to improving endovascular therapy outcomes for patients with complex lesions through clinically driven innovation. Learn more about Reflow Medical 🌐 Website: reflowmedical.com/ 💙 Spur: reflowmedical.com/spur/ Follow Life of Flow 📲 Instagram: @LifeofFlowPodcast 👍 Facebook: Life of Flow Podcast 💼 LinkedIn: Life of Flow Podcast 🐦 X: @VascularPodcast If this episode clarified how you think about below-the-knee disease and durability, share it with a colleague who would value the discussion. And if you’re enjoying Life of Flow, a quick review helps other physicians find conversations like this.

A conversation that starts with one set of “normal” labs and quickly turns into a deeper question: what does “healthy” mean? In this week’s episode, Lauren Colletti walks through how she evaluates patients beyond standard ranges, why so few people are truly metabolically healthy, and how tools like peptides, continuous glucose monitoring, and advanced labs are being used in practice today. The episode moves between clinical reasoning and real-world experimentation, including what changed when Lucas became the patient. 04:30 Why “normal” labs may not mean optimal health 04:54 Only 12% of people are metabolically healthy 06:44 What peptides are and how they work 10:32 Curiosity, self-experimentation, and patient empowerment 17:08 Case breakdown: labs, symptoms, and treatment plan 23:12 Immediate changes in sleep, recovery, and performance 28:35 What technology can’t replace: human connection in care 33:15 Is ChatGPT your new doctor? 46:00 Innovation, risk, and pushing beyond traditional models 55:00 Lauren’s clinic and Soul Women initiative Who Should Listen Physicians, clinicians, and healthcare professionals who are thinking about prevention, metabolic health, or integrating newer tools into patient care. About Lauren Colletti Lauren Colletti is a board-certified Nurse Practitioner in functional medicine and anti-aging medicine. She has been working in the space for about 15 years, focusing on identifying root causes of health issues and integrating advanced testing and therapies into patient care. She is the co-founder of Alive and Well, a clinic with multiple locations, and the founder of Sol Women, a program focused on helping women navigate midlife through functional medicine, coaching, and community. Connect with Lauren 💼 LinkedIn: Lauren Colletti 📲 Instagram: @laurencolletti_fnp Follow Life of Flow 📲 Instagram: @LifeofFlowPodcast 👍 Facebook: Life of Flow Podcast 💼 LinkedIn: Life of Flow Podcast 🐦 X: @VascularPodcast If this episode changed how you think about prevention, metabolic health, and what it means to optimize your own physiology as a clinician, share it with a colleague who’s navigating the same questions. And if you’re enjoying Life of Flow, a quick review helps other physicians find conversations like this.