Device could help prevent deaths from blood clots

June 22, 2010 6:40:22 PM PDT
An advanced surgical device could help prevent one of the most common forms of preventable hospital deaths. The challenge is getting rid of dangerous blood clots without allowing them to break loose.

One patient who recently underwent surgery had one leg swollen to nearly twice its normal size. A large blood clot was causing a condition called "deep vein thrombosis" or DVT.

"He could not walk. That's why he was admitted. His leg was so swollen and so painful," says Soo Kim, M.D.

Doctors at John Muir Medical Center used a specialized catheter to remove the clot and clear the vein. There is more at stake than just patients' comfort. DVT kills an estimated 100,000 Americans a year.

For decades, the main technique for treating DVT has been to give the patient blood thinners or to try traditional surgical techniques to remove the clot, but there has always been the danger of the clot breaking loose.

"They stand up and start walking and a big clot that has been developing in their legs will break off and go to the heart, and from there to the lungs, causing pulmonary embolism," explained Tej Singh, M.D., at the Palo Alto Medical Foundation. "And, that is very a common cause of hospital deaths."

Singh is also using the trellis catheter. It is inserted into the vein then two balloons are inflated at both ends of the clot to seal it off. A wire fed through the catheter vibrates to break up the clot.

"And, as this wire will spin, we'll be delivering what we call 'TPA,' a clot-buster medication, and while I do this for about three to five minutes, I'm then done," Singh says.

College student Rose Kirby had the trellis procedure to clear a potentially deadly clot in her arm.

"It went from my mid-upper arm through my shoulder," she says. "Now, the only limitations are the blood thinners that I have to be taking."

In the operating room at John Muir, Soo Kim took about two hours to insert the trellis and begin breaking up the clot. The remnants of that clot were removed through a separate tube, a procedure that could potentially lead to much shorter recovery times.

"I expect him to have full recovery in 24 to 72 hours at the latest," Soo Kim said. "But, I can tell you this. He's going to walk out of here."

The patient is now at home recovering.


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