More than 600,000 people in the United States suffer a pulmonary embolism — the obstruction of an artery in the lung, usually by a blood clot — each year, and at least 10 percent die within an hour after symptoms begin. More than 90 percent of the blood clots that cause these embolisms result from deep vein thrombosis (DVT), a condition in which a blood clot forms in one or more of the deep veins in the body, usually the legs. If a blood clot breaks loose, it can travel to your lungs and cause a pulmonary embolism.
Although DVT is most common in people older than 60, it can occur at any age.
"In about half of all cases of deep vein thrombosis, there are no symptoms," says Dr. Tod C. Engelhardt, a cardiovascular-thoracic surgeon at East Jefferson General Hospital. "But the signs to watch out for are leg swelling, leg pain or tenderness, and redness or warmth in the leg. Many times, the first sign of deep vein thrombosis is a pulmonary embolism."
Engelhardt advises anyone who has the following symptoms to seek medical attention immediately as they are warning signs of a pulmonary embolism:
• Sudden, unexplained shortness of breath,
• Chest pain or discomfort that gets worse when you take a deep breath or cough,
• Fainting or feeling lightheaded or dizzy,
• Coughing up blood,
• Rapid heartbeat.
A number of factors can increase your risk of developing DVT, including sitting for a long time (on a long plane or car trip), prolonged bed rest, surgery, fractures, pregnancy, birth control pills or hormone-replacement therapy, obesity, cancer, smoking and a family history of DVT.
If you are seated for long periods of time or require lengthy bed rest, be sure to get up, walk around and stretch your calves. Moving around decreases your chance of developing blood clots.
To determine whether you have DVT, your physician will ask you a number of questions and perform a physical examination. If blood clots are suspected, your physician may order an ultrasound exam or other imaging study.
Mild cases may be treated with blood thinners or anticoagulants. These won't break up existing clots, but will prevent clots from growing, as well as reduce the risk of developing new clots. More serious blood clots are generally broken up using a group of medications called thrombolytics.
"These drugs, such as tissue-type plasminogen activator (t-PA) are delivered through a catheter and break up the clot over days," Engelhardt says. "Now there is a procedure combining the use of thrombolytics with ultrasonic waves to destroy clots in hours, rather than days."
The EKOS MicroSonic™ Accelerated Thrombolysis uses microsonic energy, or vibrations, to temporarily loosen and separate the fibrins, or fabric of a blood clot, thinning them. This speeds the clot's dissolution. What previously took two to three days now takes six to eight hours.
"The old way was like dripping water on an ice cube to dissolve it," Engelhardt says. "You can do it, but it takes a while. This new system is more like dripping water into a snow cone to dissolve it; it happens much more quickly because the ice is broken up and the water can move through it more easily.
"When a person develops a DVT, there is a window of opportunity in which the clot can be dissolved and normal blood flow restored. This treatment is most effective when the clot is relatively new, usually when you have had symptoms for less than 30 days."
Another use for the microsonic thrombolysis is to treat blockage of blood flow from acute thrombosis or clotting, usually in one of the extremities. This can lead to nerve damage, paralysis or gangrene in the affected area due to lack of oxygen. The system can minimize the debilitating or potentially life-threatening outcomes by restoring oxygen to the area more quickly than before.
"It's also a safer alternative for both the treatment of DVT and PAO, with decreased risk of damaging red blood cells and the valves or vascular walls," Engelhardt says. "It's four times faster than the previous procedure and has fewer side effects."