Attacking monster clots

A blood clot as long as a toddler, that's what one man had inside his body.

He had a condition that strikes up to 600,000 people each year. His doctor says a device that's revolutionizing the way he attacks clots may have saved the patient's life.

76 centimeters, 30 inches, two and a half feet, that's how big the blood clot was in Gerry Cunha's body.

"I just couldn't imagine two and a half feet of clotting," says Gerry Cunha a DVT Patient.

It was deep vein thrombosis or DVT.

"It is a clot that forms in the deep veins of the leg," says Dr. Warren Swee, MD, MPH, a Vascular and Interventional Radiologist at South Florida Vascular Associates, Coconut Creek, FL.

The clot went from below his knee to his lower abdomen. The traveling salesman was in trouble.

"I could hardly walk. I was in such horrible pain," describes Cunha.

There was a serious chance of pulmonary embolism. The clot could break off, enter his lungs, and kill him. So in a letter, he told his wife goodbye. "I will always be near you."

But she didn't have to read it thanks to this.

The EKOS System goes into the leg, and through the blockage to deliver clot-busting medication like other catheter devices. But the EKOS adds ultrasound. Doctor Warren Swee says the vibration better penetrates the clot making it easier to dissolve.

"It cuts down the time and the amount of clot-busting medication we need," says Dr. Swee.

He tells us it requires half the time and half the medication of similar procedures. Making it safer for patients like Gerry, who can't handle high doses of clot-busting drugs.

"So patients that may not have been a candidate before may be a candidate now," explains Dr. Swee.

Today Gerry's leg is back to normal and he's back on the road.

"I can drive about 3 to 400 miles a week," explains Cunha.

Free of a monster clot that was knocked out with tiny wires. Because of the size of Gerry's clot it took Doctor Swee two days to completely dissolve it.

While on long road trips, Gerry wears compression socks, does exercises like wiggling his toes and gets out for short walks to help prevent another clot from forming.

To prevent them while on long flights, walk around the plane every hour or two, change positions in your seat, drink lots of fluids and try not to cross your legs.


REPORT: MB # 3465

BACKGROUND: Deep vein thrombosis (DVT) is a medical condition that occurs when a blood clot forms in a deep vein. These clots usually develop in the lower leg, thigh, or pelvis, but they can also occur in the arm.
It is important to know about DVT because it can happen to anybody and can cause serious illness, disability, and in some cases, death. The good news is that DVT is preventable and treatable if discovered early. (Source: CDC)

DVT COMPLICATIONS: The most serious complication of DVT happens when a part of the clot breaks off and travels through the bloodstream to the lungs, causing a blockage called pulmonary embolism (PE). If the clot is small, and with appropriate treatment, people can recover from PE. However, there could be some damage to the lungs. If the clot is large, it can stop blood from reaching the lungs and is fatal.

In addition, nearly one-third of people who have a DVT will have long-term complications caused by the damage the clot does to the valves in the vein called post-thrombotic syndrome (PTS). People with PTS have symptoms such as swelling, pain, discoloration, and in severe cases, scaling or ulcers in the affected part of the body. In some cases, the symptoms can be so severe that a person becomes disabled. (Source: CDC)

THE NUMBERS: The precise number of people affected by DVT/PE is unknown, but estimates range from 300,000 to 600,000 (1 to 2 per 1,000, and in those over 80 years of age, as high as 1 in 100) each year in the United States.

Estimates suggest that 60,000-100,000 Americans die of DVT/PE (also called venous thromboembolism).
(Source: CDC)

REVOLUTIONARY TREATMENT? Dr. Warren Swee says the EKOS System has revolutionized the way he treats DVT. The device, which utilizes ultrasound technology, takes less time and uses less clot-busting medication to dissolve potentially dangerous clots. Doctor Swee tells Ivanhoe because of the reduced time and need for medication, more people are eligible for the EKOS procedure versus other DVT catheter procedures.


* Penetrates clots, in difficult-to-reach places, such as behind valves
* Exposes clot to greater drug uptake
* Captures drug within clot
* Uses 50-70% less lytic drug
* No thrombus fracture or breakage, reducing the risk of distal embolism
* No hemolysis. Does not fracture red blood cells, so there is no adenosine and no additional compromise to renal function
* No damage to valves or the vascular wall
* Higher level of vessel patency, removes the thrombus more completely, possibly reducing the risk of Post-Thrombotic Syndrome (PTS)
* Minimizes time in the vascular lab, reducing radiation exposure


Warren Swee, MD, MPH
South Florida Vascular Associates

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