MUSC: Life-saving Blood Clot Procedure

Signs of a potentially fatal blood clot are shortness of breath, chest pain, acute anxiety, dizziness or passing out, and rapid heart rate.

MUSC HEALTH OFFERS LIFE-SAVING BLOOD CLOT PROCEDURE

A pulmonary embolism is a condition in which one or more arteries in the lungs become blocked by a blood clot. The clot, or embolus, can form in a matter of hours and travel through a vein in the leg to the lung, creating a life-threatening condition. If not treated, between 25 and 30 percent of patients can die; the mortality rate drops to 8 percent if patients are treated effectively, says Dr. Abdallah Kamouh, director of cardiology at MUSC Health Florence Medical Center.

Kamouh, an interventional cardiologist, was among the first to treat patients in the Pee Dee region using a largeBore pulmonary aspiration thrombectomy (PT), an advanced procedure technique removing the clot from the lung arteries. He used PT to treat patients with large clot burden in shock status, with rapidly worsening respiratory conditions, who are not able to be treated or who have not responded to the clotbusting drug tPA. In a pulmonary thrombectomy, surgeons insert a large, hollow catheter into a vein in the patient’s leg and, using guided imaging, thread it up throughout the right side of the heart into the lung arteries to suction out the clot. While suctioning the clot, most of the blood will be filtered and returned back to the patient. A large amount of well-formed clots is usually removed during the procedure, and imaging will confirm significant improvement of blood flow to the lungs. “The treatment can be challenging to perform, but life-saving for patients. Pulmonary thrombectomy has shown to improve the patient’s clinical symptoms significantly in the short and long term. it improves function in the right side of the heart, lowers blood pressure in the lungs, and in the short term can prevent a stay in the ICU and gets the patient out of the hospital quicker, says Kamouh.”

The inpatient procedure, performed while the patient is awake under light anesthesia, takes about one to two hours. Patients typically remain in the hospital for one to two nights, he says. Time is critical, Kamouh says. “The longer the clot is lodged in the artery, the more difficult it is to treat. If it’s older than 48-72 hours, the efficacy of the procedure will decrease significantly. Often, this procedure is performed within 24 hours of diagnosis”. Common signs of a potentially fatal clot are severe shortness of breath, chest pain, acute anxiety, dizziness or passing out, and rapid heart rate. About 25% of patients with Pulmonary Embolism die suddenly. Someone can develop a clot at any age, Kamouh says. Those most susceptible include individuals who have recently had surgery and have to be still in bed for days, people who sit for long periods of time without moving, such as passengers on long flights, and women who take birth control pills. Kamouh says the advanced pulmonary aspiration thrombectomy is a definite improvement over prior treatments that provided only limited efficacy. This newer technology has shown promising data in ongoing clinical trials especially given the advantage of the rapid and complete evacuation of proximal and large thrombi. “The clot-busting tPA, although efficacious in some cases, carries significant risk mainly major life-threatening bleeding that’s why many physicians are often hesitant to use it, especially in patients at risk.” Pulmonary thrombectomy for qualified patients has fewer complications and significantly reduces morbidity and mortality. “Not only is it life-saving; it is life-changing.”

Dr. Abdallah Kamouh is an interventional cardiologist at MUSC Health-Cardiology in Florence. For more information or to schedule an appointment please call 843-674-4787 or visit MUSCHealth.org/florence.