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Stanford study recommends change in treating pulmonary embolisms
Date:10/27/2009

ready done everything they could to save her.

She had been given an intravenous infusion of potent clot-busting medicine, a treatment called systemic thrombolysis, but that had already failed.

Kuo was initially consulted to perform a minor procedure placement of a special filter in the major abdominal blood vessel to prevent more clots from traveling from the legs to the lungs, but he knew it would do little to save her. And then an idea came to him.

"I had been reading about experimental catheter-based treatments to remove these clots from the lungs," Kuo said. "I told the staff, 'We can do more than just insert a filter. We can go after these clots using specially-designed catheters.' The ICU staff was at first skeptical, but I just kept insisting because I knew it might save her life. We quickly obtained consent from the family and went ahead with it."

As a vascular and interventional radiologist, Kuo is experienced in guiding and maneuvering catheters and wires through blood vessels using real-time radiologic imaging. He uses these techniques to reach diseased areas and to treat a variety of conditions without open surgery. Kuo knew how to perform this type of targeted, less-invasive treatment.

He quickly made a small incision in the patient's neck, inserted a catheter a thin plastic tube into the blood vessel. He then used real-time X-ray images (fluoroscopy) to guide the catheter, navigating through the heart and finally reaching the blood clots within the lungs. First, he injected clot-busting medicine through the catheter directly into the clots. Then, he used the catheter to mechanically break up the clots. Finally, he suctioned them out.

"It was quite a rush of adrenaline," he said.

The results were immediate. The patient's oxygenation improved, her blood pressure started to rise and she no longer required the potent blood-pressure drugs to keep her alive. The angiogram showed that blood was
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Contact: Tracie White
tracie.white@stanford.edu
650-723-7628
Stanford University Medical Center
Source:Eurekalert

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