“Let’s forget this rest-in-bed stuff,” said Dr. Gerard O’Sullivan. Soon after treatment for deep vein thrombosis, he physically walks his patients down the corridor so they can prepare to leave the hospital.
O’Sullivan is an interventional radiologist — a physician who specializes in minimally invasive, targeted treatments. In mid-March at the Society of Interventional Radiology scientific meeting in Washington, D.C., he described the biggest DVT treatment advance in 40 years: using a device called the Trellis to break up blood clots faster, more completely and with fewer complications than conventional DVT treatment.
Conclusions were based on the largest DVT study group to date, using registry data for 532 patients.
DVT occurs when a blood clot partially or completely blocks blood flow in a vein. Risk factors include travel and surgery that keep people off their feet for long periods. Dangers include clots breaking off and migrating to the lungs, leading to pulmonary embolism, which causes about 200,000 deaths a year. An estimated 900,000 DVT cases are diagnosed annually, and March has been designated DVT Awareness Month.
Trellis treatment removes the blood clot right away and restores blood flow much quicker than conventional catheter-directed thrombolysis, a drug-only treatment requiring two to three days in intensive care.
How the Trellis works: Balloons are inflated on both sides of the clot to prevent pieces from traveling elsewhere in the body. Using imaging, the Trellis is guided through a catheter, then rotated to infuse clot-busting medication. Clot pieces are removed through the catheter. Average time: 22 minutes, O’Sullivan said.
Patients experienced dramatic relief of pain, swelling and skin discoloration within a few hours, said O’Sullivan, who explained other benefits. The Trellis disperses the clot-dissolving drug directly to the clot — so the drug works much faster and at lower doses, which minimizes bleeding risk.
Standard treatment with blood thinners helps prevent pulmonary embolisms but does not rid the root of the problem — the clot. An estimated 50 percent of untreated clots cause post-thrombotic syndrome, which involves chronic leg pain, swelling, ulcers, and difficulty walking and standing. Even when clots dissolve on their own, veins are permanently damaged.
O’Sullivan maintains that single-session treatments with the Trellis should become the new standard of care.
