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New method to remove lung clots in blood clotting disorders

New innovative system to treat pulmonary embolisms used for the first time at the Medical Centre - University of Freiburg

If a blood clot endangers the work of the lungs and thus the oxygen supply, rapid remedial action is required. Pulmonary embolisms are among the most frequent causes of death in cardiovascular diseases, and their treatment is often difficult. The Department of Cardiology and Angiology at the Medical Center - University of Freiburg successfully used                                    a new procedure to remove such a blood clot for the first time on the Bad Krozingen campus: the patient was able to go home a few days later.

When blood thinner is no option

In most cases, the treatment of pulmonary embolisms involves the use of drugs that are administered by drug pump over a period of about ten hours and are intended to dissolve the clot. However, this lysis therapy inhibits blood clotting, which can increase the risk of internal bleeding.

"Our patient had already experienced internal bleeding prior to the pulmonary embolism, so dissolving her blood clot with anticoagulant drugs was out of the question," reports Dr. Elias Noory, senior physician in the Department of Cardiology and Angiology at Medical Centre - University of Freiburg. "We then decided, taking into account current studies, to remove the clot mechanically with the help of a catheter."

Rapid intervention provides immediate improvement

With the new system, a flexible tube about eight millimeters thin is advanced with a catheter via the inguinal vein under local anesthesia, through the heart and into the pulmonary artery. Extreme care is of the essence here to avoid damaging the sensitive structures. X-rays are used to check whether the tube has reached the clot exactly; then the doctors pull the clot into the catheter with a wire mesh, while possible fragments are sucked out directly on site. "We were able to see that the oxygen saturation in our patient's blood increased significantly immediately after the clot was removed," Dr. Noory says. "Already towards the end of the procedure, she reported that she was breathing much better.“ The patient was able to be transferred to a normal ward just a few hours after the procedure and was discharged home a few days later.

"Especially for patients with blood clotting disorders, it is of great value to be able to offer a minimally invasive procedure for the removal of blood clots with thrombectomy," says Prof. Dr. Dirk Westermann, Medical Director of the Department of Cardiology and Angiology at the Medical Centre - University of Freiburg.

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