Ultrasound technology helps safely dissolve deep-vein blood clots

Mazen AbuAwad, M.D., an interventional radiologist at St. Anthony's Medical Center

Deep Venous Thrombosis (DVT) (a blood clot located in a deep-vein area of the body) is a serious and potentially life-threatening condition. There are about 600,000 new cases every year in the U.S., with some 60-70 percent resulting in permanent debilitating damage in affected veins and valves.

The “gold standard” for treating blood clots that form in the deep veins of the body has been oral anti-coagulation medications (blood-thinning drugs), which prevent future clots from forming. Unfortunately, these medications generally do not eliminate the existing clot, which can either travel to other sites in the body (such as the lung) or can harden and cause irreversible damage to the vein.

Mazen AbuAwad, M.D., an interventional radiologist at St. Anthony’s Medical Center, is one of only a handful of physicians in the metro area trained to use the EKOS ultrasound-assisted thrombolysis method to dissolve blood clots.

“With this method, a device is passed through the blood vessel to the site of the blockage, where it emits ultrasound waves,” Dr. AbuAwad said. “The waves crack the clot and make it porous, allowing the clot-busting drugs to dissolve it quickly and safely. This technology combines the mechanical with the chemical to clear the clot, generally in 24 hours or less.”

Most DVT cases occur in sick or hospitalized patients who have had surgery, broken limbs, cancer or a history of heart attack, stroke or congestive heart therapy. Long periods of sitting (such as in an airplane) can trigger DVT, and the use of birth control pills may be a contributing factor. Genetics also plays a big role, Dr. AbuAwad said.

Symptoms include: leg pain, tenderness or fatigue, especially when walking or standing (if located in the leg); swelling, redness or skin discoloration of the affected body part, as well as a sensation of warmth.

The ultrasound-assisted thrombolysis procedure begins with an injection of dye into the vein to determine the extent of the clot. Then an “intelligent drug delivery catheter” is inserted through the vein to the site of the clot. Once it is in place, this device emits low-power, high-frequency sound waves into the clot to loosen and thin its fibrin. At the same time, it creates ultrasonic pressure waves that force the drug deep into the clot and keep it there, so it doesn’t escape into the bloodstream.

“It takes only about a half-hour to prepare the patient, who then is admitted to the ICU for continuous monitoring overnight, as the drug drips to the clot site,” Dr. AbuAwad said. “We do a follow-up injection (through the same catheter) the next morning, and then the patient goes home.”

Following the procedure, restrictions on the patient’s physical activities are minimal – no heavy lifting or pulling for two to three days. The patient then takes oral anticoagulants for up to six months.

Dr. AbuAwad and his partner and fellow radiologist, Syed Hassan, M.D., began using the ultrasound-assisted thrombolysis method to treat DVT when it first became available, in 2005. Their practice is the second-largest user of the EKOS technology in the country, and they frequently receive patient referrals from physicians throughout the metropolitan area, Dr. AbuAwad said.

To schedule an appointment with Dr. AbuAwad or any St. Anthony’s physician, call 314-ANTHONY (268-4669) or 1-800-554-9550.

For information, please call our Health Access Line at 314-ANTHONY (268-4669) or 800-554-9550 or visit find a physician online.

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Ultrasound technology helps safely dissolve deep-vein blood clots