South Florida Vascular Associates South Florida Vascular Associates

Monday, April 23, 2012

Gerry's Story: Deep Vein Thrombosis

State-of-the-Art Technology and Quick Intervention Saves Limbs and Lives

59-year-old Margate, Florida resident Gerry recently became a deep vein thrombosis (DVT) statistic and is lucky to be alive. Gerry developed a two and half foot long blood clot that started below his knee, ran all the way up his leg, wrapped into his abdomen and up to the level of his belly button.

“They basically told me to go home and put my affairs in order. It was very frightening.”
Gerry is a classic case of DVT waiting to happen.  When his right leg began swelling, his primary care doctor diagnosed a blood clot behind the knee and prescribed an oral blood thinner to prevent the clot from getting bigger and potentially going into his lungs. It didn’t work. Within days his leg blew up three times its normal size and the pain was excruciating.

 Interventional Radiologists at South Florida Vascular Associates discovered that the clot had extended all the way up the leg and into the pelvis,  measuring almost 2 ½ feet long.

This type of DVT is rare and it is usually seen once every few months, if that. If left untreated, or treatment is unsuccessful, it could result in post thrombotic syndrome (PTS) in which the valves in the legs are damaged from the clot causing permanent disability.There is also risk of a piece of the clot breaking off and traveling to the lungs that can cause a pulmonary embolism, which can be life-threatening,

“I put my affairs in order and wrote a farewell letter to my wife just in case something went wrong. It was surreal, said Gerry..

Since the blood clot was so massive, and previous oral blood thinner medications failed, the best way to dissolve the clot and save Gerry's leg was to use a device called the EKOS Ultrasound Catheter.
Here’s how this state-of-the-art, minimally invasive device works.

Performed in a hospital Endovascular Lab, the EKOS catheter is inserted behind the knee and threaded through the clot. It uses ultrasonic energy to deliver clot busting drugs like TPA directly to the clot, causing it to break-up and dissolve like a melting ice cube, restoring blood flow much more quickly. In many cases, if the clot is less than 2 weeks old, it takes only 12-14 hours to dissolve, but in Gerry's case, the clot was 5 weeks old and so massive that it took 2 days.  Remarkably, soon after treatment, Gerry's debilitating leg pain and swelling resolved allowing him walk normally and finally return back to work.

Unfortunately, many people are not aware of this technology and should because it saves limbs and lives.  EKOS state-of-the art technology offers significant benefits over other methods for DVT treatment. It’s faster, reduces the risk of post thrombotic syndrome, and requires less clot busting medication greatly reducing the risk of bleeding complications such as brain bleeds.

Based on U.S. statistics, up to 600,000 people develop DVT each year with an estimate of over 100,000 pulmonary embolism deaths each year in the U.S.

The number of DVT cases is concerning. There’s a vital need to make people aware of the risk factors and how to prevent it and recognize early warning signs. This is the only way we can reduce these staggering statistics.

Obesity, lack of exercise, smoking, sitting too long at our desks or during long commutes; birth control pills and being over age 40 are the biggest risk factors.

As a restaurant supply sales person, Gerry spends long hours behind the wheel of his car, is overweight and was a smoker.

This experience was a real wake-up call and a great learning experience for Gerry. He quit smoking, is exercising, eating healthy and even gets out of his car when he’s been sitting too long to stretch his legs and walk around.“I’ve got a second chance at life and I’m doing it right this time!” he says. 

Thursday, April 12, 2012

U.S Adds More on Blood Clot Risk to Some Birth Control Pills

In a recent article published by Reuters, US regulators are adding information to the labels on a popular class of birth control pills that includes Bayer AG's, Yaz, and Yasmin to show that they may raise the risk of blood clots.
  
All common birth control pills increase a woman's chances of getting potentially fatal blood clots.
But the U.S. Food and Drug Administration said  that some studies showed the danger may be even higher for more recent pills that contain the compound drospirenone, a synthetic hormone.

According to the Wall Street Journal, the FDA said that women should talk to their health-care professional about their risk for blood clots before deciding which birth-control method to use and that doctors should consider a woman's risk for developing a blood clot before prescribing the drugs.

Most birth-control pills contain two types of hormones, estrogen and progestin. All types of pills increase the risk of blood clots, and product labels warn of such risk.

While the risk of blood clots is low among women who take birth-control pills, the FDA said it is higher than the risk among women who aren't taking the pills. However, the risk of blood clots from pregnancy and during the postpartum period is higher than that of women taking all types of birth-control pills.

Blood clots form inside a vein and are known as deep vein thrombosis. The clots usually form in the lower leg or thigh, but can break loose and travel to other areas of the body such as the

The FDA's own study found that 10 in 10,000 women taking pills with drospirenone would get a blood clot per year, compared with about six in 10,000 women taking older contraceptives.

A clot in blood vessels can prove fatal if it breaks loose and travels to the lungs, heart or brain.

To put the risk into perspective, the FDA added that the risk of blood clots from pregnancy is even higher than any risk from birth control pills.

The announcement comes after an advisory committee of outside experts to the FDA voted in December for a label revision for pills with drospirenone, calling for clearer information about their risks and benefits.

The experts stopped short of agreeing that these pills' risks outweighed their benefits, since some studies found the pills did not increase blood clot risks.

During a December panel meeting, some women's advocacy groups called for the pills to be taken off the market, as the studies that viewed pills favorably were industry-funded.

The consumer groups and patients shared tearful stories about sudden deaths or life-changing disabilities they or their loved ones suffered from blood clots, which they believed were caused by Yaz or Yasmin.

Most common contraceptive pills combine the hormones estrogen and progestin to help block ovulation and sperm. But they also increase the chance of a woman getting blood clots compared to not taking pills, particularly as she ages.


If you or a loved one are taking Yaz, we encourage you to check with your family physician to be sure that this is the right contraceptive medication for you.