State-of-the-art treatment removes blood clots

Interventional radiology, a minimally invasive treatment for blood clots, can help resolve this issue—quickly.

Increasingly, doctors are seeing patients, including those who had Covid, present with symptoms of blood clots. Rather than treat them using blood thinners alone, which doesn’t always work and may require being on the thinners for a long period of time, doctors at Providence St. Joseph Hospital are using new technology and minimally invasive procedures to safely remove dangerous blood clots and stop bleeding.

Tina Matic, 45, thought her shortness of breath was the result of stress. She is a teacher at a competitive school in Orange County and mom to two young teenagers. In October 2020, though, over the course of several weeks while her husband was out of town, the shortness of
breath got worse.

One morning, while on a video call with her husband, she fainted. He began shouting to her over the phone, and as she came to, he told their son to run a few blocks to his grandparents’ house for help. When they brought her to the Emergency Care Center at Providence St. Joseph, Matic remembers, “my mom was holding me up. I was very dizzy—I could tell something was super wrong.” The medical team quickly evaluated her and “within about 15 minutes they said I had deep vein thrombosis and a massive pulmonary embolism,” which required immediate intervention.

“Pulmonary embolism can be immediately life-threatening and often requires emergency intervention,” says Bhavraj Khalsa, MD, an interventional radiologist and program director of interventional oncology at Providence St. Joseph Hospital.

FAST TREATMENT IS THE BEST CURE
Matic was treated successfully by Dr. Khalsa. Using the most up-to-date technology to perform the minimally invasive procedure, he was able to remove the blood clot in her lung. Matic was back at home within four days.

A pulmonary embolism is a blood clot that has traveled to the lungs and become lodged there.
Often such clots originate in a vein deep within the body, such as in the legs, and block blood flow—a condition called deep vein thrombosis, or DVT. It can be caused by sitting for a long time during plane or car travel, trauma, surgery or simply being sedentary. Since the pandemic forced Tina to teach her classes online, she’d spent hours sitting at her computer, which, she speculates, might have led to a clot forming in her leg.

To remove a pulmonary embolism, Dr. Khalsa inserts a tube into the patient’s vein in the groin or neck. He tracks his route on a screen that displays imaging with fluoroscopy, an X-ray video, and threads the catheter up to the clot.

“Management of DVT and pulmonary embolism has traditionally been to prevent further clotting by prescribing anticoagulants [blood thinners],” explains Mahmood K. Razavi, MD, medical director of interventional clinical trials at Providence St. Joseph Hospital Heart and Vascular Center.

But recent studies show that this is not always enough. “Many patients will suffer from long-term consequences if the clot is not cleared from the veins in time,” Dr. Razavi says. “Our team at St. Joseph Hospital is internationally recognized for effective interventional management of blood clots through minimally invasive methods to improve long-term outcomes. We use the latest devices, techniques and technologies to clear and remove the clot in attempts to get the veins back to their original shape.”

INTERVENTIONAL RADIOLOGY TREATS MORE THAN BLOOD CLOTS
The Providence St. Joseph interventional radiology team, he adds, has played important leadership roles in the key clinical trials that addressed the unmet needs of patients with deep venous disease. Dr. Razavi himself has contributed to the medical literature with original research.

As an interventional radiologist, Dr. Khalsa collaborates with a number of physicians at Providence St. Joseph. “We can deliver tiny particles loaded with chemotherapy or radiation
to treat liver cancer, block the blood supply to fibroids to treat uterine bleeding, shrink an enlarged prostate, stop bleeding from hemorrhoids, improve pain from knee joint arthritis and treat varicose veins, all through a catheter the size of a ballpoint pen inserted through the wrist or groin,” he says.

Tina Matic has fully recovered and is grateful that she arrived at Providence St. Joseph in time to receive the excellent care from Dr. Khalsa and his team. “Dr. Khalsa has connected me with other specialists for continued monitoring of my health long-term,” she says. “It makes me feel like he is caring for me even into the future with an expanded team of doctors, which is very reassuring.”