Physicians at Emory University Hospital recently performed for the first time in the United States a procedure called Ultrasound Assisted Thrombolysis to destroy a deadly blood clot in a patient suffering from deep vein thrombosis.
The procedure was performed by Abbas Chamsuddin, MD, associate professor of interventional radiology in the Emory University School of Medicine, to relieve a major system of clotting that filled the veins of the patient's leg, pelvis and inferior vena cava leading up to the heart.
Deep vein thrombosis (DVT) is a blood clot in a deep vein, usually found in the legs. These clots can, in turn, form in superficial veins in deep veins. While blood clots in superficial veins rarely cause serious problems, clots in deep veins (deep vein thrombosis) require immediate medical care.
According to Dr. Chamsuddin, ultrasound assisted thrombolysis incorporates use of a tiny catheter that houses an ultrasound wire and medications which slowly dissolve the clots.
"Ultrasound assisted thrombolysis uses a catheter that houses an ultrasound wire which causes fragmentation of the clot, while dripping clot busting medications are then delivered," says Dr. Chamsuddin."
The catheter-based drug delivery system combines the use of targeted drug delivery catheters and the therapeutic benefits of a high frequency low power ultrasound. The incorporation of ultrasound, says Dr. Chamsuddin, allows physicians to loosen tightly knit fabrics found within a blood clot called fibrin.
"The ultrasound helps temporarily loosen and separate the fibrin for more blood clot permeability," explains Dr. Chamsuddin. "The loosened fibrins then allow for reception of the infusion of clot-busting medications, which then slowly dissolve the blockage - usually within two to three days."
Emory houses two of the machines that are used for this procedure (called Peripheral Infusion Systems).
Other treatments for deep vein clots typically include use of blood thinners such as heparin and warfarin. Heparin is given through a vein (intravenously, or IV) or as an injection. Warfarin is given as a pill. Treatment usually involves taking blood thinners for at least three months to prevent existing clots from growing.