NASCAR driver Byran Vickers had it. While embedded with Army troops covering the war in Iraq, NBC journalist David Bloom lost his life because of it. It's called deep vein thrombosis (DVT), a condition in which a massive clot develops in the legs of air travelers, hospital patients or others who don't move for long periods of time. When the clot breaks off, it can travel to the lungs, resulting in a pulmonary embolism that can severely reduce blood flow to the lungs and can be fatal. Symptoms of DVT may include leg pain, swelling, discoloration, and warmth to the touch. Diagnosis of the condition is frequently performed with ultrasound.
Developed in the 1950s, traditional treatment for DVT includes the use of blood-thinning medication and compression stockings. The medication prevents further development of clots, but doesn't address the existing clot which can take weeks or months to resolve. There is a small but persistent risk of pulmonary embolism until the clot has resolved.
The presence of a clot in the veins of the legs can cause permanent damage to the valves in these veins. If these valves stop working, a chronic, painful swelling of the legs can develop, called post-phlebitic syndrome. This syndrome occurs in up to 50% of patients with DVT within one year.
At French Hospital Medical Center, (FHMC), a new device called the Trellis Peripheral Infusion System is being used to treat lower extremity DVT. FHMC is the only hospital from Monterey to Ventura to offer its patients this technology. The catheter-based procedure is usually completed in about an hour. The procedure is done under IV sedation.
"The Trellis device is an infusion catheter with an inflatable balloon on both ends," explains Diagnostic and Interventional Radiologist Timothy Auran, MD. "We place the device into the affected blood vessel and inflate both balloons. We then infuse a clot dissolving medicine to break down the clot. The liquefied clot is then aspirated out of the catheter at the end of the procedure. The medicine works in less than ten minutes and only affects the thrombosed vein."
The Trellis device not only prevents pulmonary embolism, but helps prevent the development of post-phlebitic syndrome. The patient goes home within 24 hours of the procedure and is usually able to return to normal activity within one to two days. The Trellis device is an addition to a range of DVT treatment options that have already been available at French Hospital, including inferior vena cava filters, suction thrombectomy devices, and standard thrombolysis infusion catheters.
"The key is identifying those people who are at risk," says Dr. Auran. "We need to treat patients with Trellis within two weeks after the onset of symptoms. The sooner they get to their physician, the better chance we can treat this successfully."