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Cure for Deep Vein Thrombosis?

New Technique Dissolves Blood Clots in Leg, Relieves Symptoms

DVT Symptoms Gone

According to the Society for Interventional Radiology, 60% to 70% of DVT patients suffer post-thrombotic syndrome. These people have abnormal pooling of blood in the leg, chronic leg pain, fatigue, swelling, and sometimes even severe skin ulcers.

And about half of DVT patients suffer a second DVT, says Jorge J. Guerra Jr., MD, professor of vascular/interventional radiology and associate vice president for clinical affairs at the University of Miami Miller School of Medicine.

Guerra is impressed that in the Chang study, which followed patients for an average 3.4 years -- and up to 8.5 years -- none of the patients had a second DVT and none of the patients suffered further vein deterioration.

"By getting the veins back to normal, he is preventing a second DVT, which is more disturbing than a first one," Guerra tells WebMD. "This is a laudable study."

Dissolving DVT Clots: Lots of Doctor/Patient Time, Patience

To treat DVT patients, Chang and colleagues started off with standard anticoagulant treatment. Despite this treatment, they found that 40% of patients already had a pulmonary embolism; fortunately, these were not fatal.

Next, patients had to be treated within two weeks of suffering their DVT, while the clots were still fresh. Once a DVT clot hardens, Chang says, the treatment will not work.

During treatment, NIH interventional radiologists painstakingly threaded catheters into the tiny veins blocked by blood clots. This process took as long as four and a half hours, Chang says.

But that's not all. The doctors then "laced" the clot with tPA by repeatedly injecting small amounts of the drug through the catheter as they slowly moved it along the clot. There could easily be 100 small injections at 30-second intervals, Chang said.

The procedure is then repeated up to four times as needed, although the most time-consuming part -- threading the catheters into the veins -- does not have to be repeated. Most patients needed two or three treatments.

"We will have to bring the time down. We have to make it simpler. But then, eventually, we will see a practical treatment," Chang says.

"This is tedious as hell. And most of us don't have just one set of veins in the calf, but duplicate veins -- so it's a double procedure," Guerra says. "But if it can save those people with post-thrombotic syndrome, you might be doing a large service, particularly in young women, who get a double whammy: a swollen leg covered with spider veins."

If the procedure is tough on the doctor, it's no easier on the patient.

"I am not sure what they did with the others, but they did not put me out on the first day," McDonald says. "I'd just had a baby three weeks before, and I have back problems, so that was the hardest part. There were three catheters, two in my groin and one in my neck, and my back was in spasms the whole time. I cried for the whole eight hours of the procedure. The next day they put me out. That was better."

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