New procedure removes blood clots without surgery

Up to 300,000 people will die this year from deep vein thrombosis, or DVT. It causes blood clots in the leg that can travel to the lungs or heart.

Now a new, surgery-free treatment is fishing out the killer clots and sending patients back to normal living the next day.

Rescue dogs Daisy and Heidi are the light of Janice Kelly's life, but they don't leave much room for slowing down.

But she had to when her leg started throbbing.

"I could not get down on my hands and knees on the floor," says Janice.

She dismissed the pain as part of the healing process from a broken foot. A trip to the hospital weeks later changed everything.

"I didn't realize the seriousness of it until they told me they were transferring me to another hospital," says Janice.

Janice had a blood clot that was nearly two feet long, from her knee to her hip. A piece of the clot had already traveled to her lungs.

Traditional treatment for Janice would mean months or up to a lifetime of blood thinners, leaving her at risk for another lung blockage or excessive bleeding.

Instead, doctors used a new treatment to "fish out" the clot. In a one-hour procedure, surgeons inserted a small tube behind Janice's knee, inflated a balloon at each end of the clot, and filled the space with medication.

"It actually isolates the area that we're going to treat with balloons so that nothing escapes from the area you're treating," says Dr. Mark Ranson, a vascular surgeon at the Florida Hospital Cardiovascular Institute in Orlando. "That way, it eliminates the risk of the clot going to the lung."

A vibrating wire helps dissolve the clot, which is then pulled back out through the same tiny space behind the knee. Janice was up and walking the next day.

"I have basically been able to resume a normal life and not have to worry about it," she says.

She is done worrying about herself, and back to focusing on her best friends.

The new clot-busting procedure is done under sedation. Most patients go home on blood thinners for a short period of time after the procedure to prevent re-clotting.

Several factors leave a person at risk for DVT including old age, narrowed veins and being immobile for a long period of time, including airplanes or cars.


RESEARCH SUMMARY
TOPIC: DISSOLVING DANGEROUS CLOTS
REPORT #1665

A SILENT KILLER: While arteries are responsible for bringing blood from the heart to the rest of the body, veins do the opposite. They return blood back to the heart. There are three types of veins: superficial veins lie close to the skin, deep veins lie within groups of muscles and perforating veins connect the superficial veins to the deep veins. Deep veins connect to the body's largest vein -- the vena cava -- which runs directly to the heart. When a blood clot forms in one of the deep veins, a potentially life-threatening condition called deep vein thrombosis (DVT) develops. The condition most commonly occurs in the pelvis, thigh or calf, according to the Society for Vascular Surgery.

DVT becomes dangerous when the blood clot breaks free from the vein and travels through the bloodstream to the lungs, causing a pulmonary embolism. An embolism can block blood flow in the lungs, causing a strain on both the heart and lungs. A large pulmonary embolism can be fatal.

SYMPTOMS: It's sometimes difficult for patients to recognize the symptoms of DVT, and about half of all cases don't cause any symptoms. Signs to watch out for include swelling and tenderness in the leg, leg pain that worsens when walking or standing, a sensation of warmth and skin that turns blue or red. Experts say you are at higher risk for DVT when you aren't able to move for long periods of time such as in a hospital bed. This causes blood to pool and form clots. Other risks include obesity, history of heart attack and pregnancy.

TREATMENT: The most common medications used in the treatment of DVT are blood thinners like warfarin and heparin. Blood thinners are often administered by injection at first, followed by treatment in pill form for three to six months. The most common side effect of this type of treatment is bleeding, which can be life-threatening. Compression stockings are another therapy administered to reduce swelling and prevent blood from pooling and clotting in the leg. For serious cases of DVT, surgeons sometimes perform thrombolysis. During the procedure, a vascular surgeon uses a catheter to inject drugs directly into the clot to dissolve it. In another procedure called venous thrombectomy, surgeons completely remove the clot.

FOR MORE INFORMATION, CONTACT:
Jennifer Roberts
Florida Hospital Media Relations
Orlando, FL
Jennifer.n.Roberts@flhosp.org


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