Patients suffering from blood clots, deep vein thrombosis (DVT) and superficial thrombophlebitis can turn to the surgeons at the Division of Vascular and Endovascular Surgery at Mount Sinai Beth Israel for the latest minimally invasive therapies.
When is it needed? When a blood clot develops in a blood vessel, it reduces or blocks blood flow through the vessel. Another danger connected with blood clots is that a piece can break off and travel through the circulatory system to other parts of the body. If this piece lodges in the lungs, the result can be a fatal pulmonary embolism. During Lysis therapy, a catheter filled with clot-dissolving drugs eliminates the clot. The therapy can be used to treat clots in veins and arteries.
What happens? After making a small incision into an artery in the groin, doctors insert a catheter (a very thin tube) filled with clot-dissolving medication, and guide it directly to the clot. When the catheter reaches the blockage, it releases clot-dissolving drugs which dissolve the clot. The catheter may also be equipped with a tiny tool that breaks up the clot.
When is it needed? This procedure is used to break up a blood clot that is partly or completely blocking blood flow in vein or artery. It is sometimes used before angioplasty to remove dangerous blood clots, making the angioplasty procedure safer and more effective.
What happens? A device is attached to a catheter that is inserted into a vein or artery. The catheter and device are guided to the vein or artery with the blood clot. There, the AngioJet pump shoots a saline solution under high pressure directly at the blood clot, breaking it up. Next, it suctions all pieces of the clot back into the pump. The benefit is that a clot is removed entirely rather than being dissolved with medicine alone, which has higher incidence of bleeding, and it eliminates the possibility that tiny pieces can move downstream and cause more problems.
When is it needed? This procedure is typically used to treat deep venous thrombosis (DVT) in high risk patients, or those who failed blood thinner therapy. When a blood clot forms in the deep veins of the leg or pelvis, the greatest danger is that it will break up and large pieces will travel to the lungs, blocking oxygen flow and causing a potentially fatal pulmonary embolism.
What happens? A small filter is placed inside the body's largest vein in the abdomen (inferior vena cava), which returns blood from the lower body to the heart. There, it traps large clot fragments, preventing them from traveling to the lungs and heart. Normal blood flow continues around the trapped clot, which breaks down over time. This procedure is done on an outpatient basis, allowing patients to return home the same day.
Most IVC filters are temporary–these optionally retrievable filters can be removed up to 1 year after the initial placement.