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Serena Williams' Pulmonary Embolism, Hematoma: FAQ

Tennis Star Recovering From Life-Threatening Blood Clot

What is the treatment for pulmonary embolism? continued...

If a severe pulmonary embolism is confirmed, more urgent treatment may be necessary.

"If the embolism is very severe and the patient is at risk of dying, with blood pressure dropping, there is a procedure called pulmonary embolectomy, where we go in through a vein [with a catheter] and make attempt at removal of the clot. This is done rarely," Shafazand says.

Another emergency treatment for pulmonary embolism -- also rarely done -- is to use the clot-busting drug tPA to open the clogged artery.

Did Williams undergo an embolectomy? That isn't yet known, but it's unlikely.

Williams did undergo a procedure. This may have been simply a diagnostic procedure to take a close look at her pulmonary embolism.

Another typical procedure in patients who have suffered a pulmonary embolism is to insert a filter into the major vein leading to the heart  -- an inferior vena cava (IVC) filter -- to catch any future clots that come along.

Why did Serena Williams have a hematoma? What is a hematoma?

People magazine reports that Williams suffered a hematoma from her treatment for pulmonary embolism.

A hematoma is a bruise -- a collection of blood beneath the skin from a leaky blood vessel.

"A hematoma could happen with any procedure where they have to enter vein or artery," Shafazand says. "If it is a large enough hematoma, it would be drained and if the artery beneath it is still leaking, it would be repaired."

Will Serena Williams ever play tennis again?

Pulmonary embolisms usually are not removed because the body eventually reabsorbs the clot over time. Some people fully recover, others do not.

"For most patients, the recommendation is they go on some form of anticoagulant [blood thinner] for at least three to six months, Shafazand says. "For a subset of patients, their pulmonary embolism may lead to pulmonary hypertension -- meaning there has been damage to the pulmonary arteries. In these cases, the blood pressure in the pulmonary artery is high and this has many implications down the road for the patient's health."

WebMD asked Shafazand whether Williams is likely to return to competition.

"It all depends on how her heart and lungs respond in the future in terms of recovery," she said. "In three to four months, her doctors will have to see if her pulmonary embolism is completely resolved and her heart has the proper response to exercise."

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