Pulmonary embolism (PE) is a condition in which the arteries of the lung are blocked by a blood clot that can come from various parts of the body.
Presence of pulmonary emboli in the lung essentially "chokes" the pulmonary circulation leading to elevated pressures in the pulmonary arteries, which then causes strain on the right chambers of the heart, causing enlargement and reduced pumping function.
Symptoms are usually shortness of breath, chest pressure or pain, as well as dizziness and passing out spells. A person’s oxygen saturation and blood pressure may also be low.
The condition can be a life-threatening situation, and if left untreated, the mortality could be as high as 30%. Unfortunately, as many as 10% of pulmonary embolism patients experience sudden cardiac death.
Fortunately, there has been significant advancement in the understanding and treatment of pulmonary embolism. The standard treatment for PE includes blood thinners and clot dissolving medications, however, a problem arises when due to bleeding history a patient is unable to take these medications, or the medications and blood thinners are insufficient to treat the patient and they become very symptomatic.
McLaren Flint offers a new technology to treat pulmonary embolism which involves a minimally invasive procedure in which the blood clot in the lung is sucked out by a catheter introduced through the groin (INARI mechanical thrombectomy).
The catheter is equipped with a special suction device that helps to aspirate clots also known as "mechanical thrombectomy". Under x-ray guidance the catheter is delivered to the location of the blood clot in the lung. Angiograms of the lung vessels are taken to get a road map of the arteries, and pressure measurements are obtained. The blood clot is then aspirated.
“In patients with a high bleeding risk, where blood thinners and clot dissolving medicines cannot be given safely for the fear of excessive bleeding, the INARI suction catheter technique is very valuable,” said Ahmad Munir, MD, board-certified interventional cardiologist and Director of Structural Heart disease at McLaren Flint. “Additionally, there are other criteria which are evaluated by various imaging techniques and the clinical condition of the patient to decide on the best treatment option.
“In McLaren’s ER, we have the ability to rapidly diagnose pulmonary embolism and its consequences with a CT scan as well as an emergent echocardiogram. The status of the right heart chambers is also evaluated in the perspective of a patient’s clinical symptoms and physical signs. There are protocols developed to tailor to the patient’s clinical condition.”
Once a patient has the INARI mechanical thrombectomy, the other important task is to evaluate the cause of the blood clots. Some people do have an inherent tendency to form blood clots due to a genetic condition. In other people prolonged immobilization such as taking a long car ride leads to stagnation of blood in the legs which results in blood clot formation.
Other clinical conditions such as cancer can predispose someone to formation of blood clots in the legs. The structural heart team usually sends patients to the appropriate specialists to evaluate and treat these types of causative factors.
“McLaren Flint is taking a leadership role in developing a specialized team to help patients with pulmonary embolism,” added Dr. Munir. “Our multidisciplinary team is able to evaluate and recommend an appropriate treatment plan based upon each individual patient's clinical condition.”
To learn more, go to mclaren.org/flintheart