March 16th, 2007 03:13 EST
The Silent Epidemic
Deep Vein Thrombosis. Sound familiar? Maybe you heard about it recently when Vice President Dick Cheney was diagnosed with the disorder. Still doesn’t ring a bell? Don’t worry, you’re not alone. Almost 60 percent of Americans have never heard of DVT, although it affects up to two million people here every year, according to experts.
Vanessa Belton-Hubbard was in the dark too, until at a PTA meeting she noticed one of her ankles was swollen. She later discovered the entire leg was swollen as well, and at the doctor’s office she learned she had a blood clot that extended from her ankle to her thigh. Left untreated it could travel to her lungs and heart –– even to her brain if neglected long enough –– and kill her.
“I was terribly frightened,” she said.
And with good reason. DVT starts as a clot in the lower leg and can develop for a number of reasons, including having varicose veins; sitting for long periods in a car or plane; taking birth control pills; pregnancy, especially the time period immediately after giving birth; being obese; or it could be inherited. If discovered too late it could develop into an embolism, which can obstruct blood vessels. Experts say DVT kills more people in the United States than breast cancer and AIDS combined.
Hubbard had been taking birth control pills when she was diagnosed. In her late forties, she experienced pain in her leg for several days, but was unaware that it was a sign of something serious. Eventually, she walked with a limp and her leg was hot when touched.
“I could hardly walk because my leg was literally three times its normal size,” she explained.
To add to the confusion, a recent survey conducted by the Coalition to Prevent DVT, discovered that while physicians were twice as likely as the public to know about DVT, less than a quarter of the physicians surveyed reported that they educate their high risk patients about it, while only half prescribe medications to them; which might explain why Hubbard was unaware she was experiencing symptoms.
“DVT can be a life and death matter, yet we have the power to fight this condition,” said Larry Wellikson, MD, FSCP, a coalition member.
Hubbard’s physician prescribed blood thinners, the most popular treatment option, to help decrease the blood from clotting and to prevent the clot from growing. However, this type of treatment –– taken either orally or via injection –– doesn’t break up the clot. The body does this naturally over time. But researchers in the field say that this method, while effective, still leaves room for damage to the veins in the leg because dissolution takes time, resulting in permanent disability and pain. In addition, studies show the 50 percent of people treated with blood thinners for DVT in the leg, developed a condition called post-thrombotic syndrome, causing leg pain, swelling, and skin thickening, from blocked vein valves and a restriction of blood flow in the vein from the residual clot.But a new technique presented at this year’s Society for Interventional Radiology’s Annual Scientific Meeting, demonstrated a method that not only breaks up the clot but removes it from the body as well. Termed the rapid lysis technique, researchers combined a clot-dissolving drug with a clot removing device. Using imaging, a catheter is first guided into the vein to the blood clot, where it is sprayed with the drug at high force to help break it up. A power saline jet within the device creates a vacuum that draws the clot into the catheter as it is withdrawn out of the vein in a spiraling motion.
“The new combination technique offers a significant advancement in the treatment of DVT, often allowing the interventional radiologists to break up the clot in one treatment,” said Mark Garcia, M.D., an interventional radiologist from Wilmington, DE who helped author the study. “It has worked on even the largest, most difficult clots and could become the new standard technique, potentially changing the way all DVT patients are treated.”
This breakthrough gives hope to victims like Hubbard who can no longer walk for long periods, an activity she previously enjoyed. Sometimes she travels with a cane. But the Coalition has designated March as National DVT Awareness Month, a grassroots educational campaign to publicize DVT. Melanie Bloom is the organization’s national patient spokesperson. Her husband David Bloom, worked as a journalist for NBC news, and died of a pulmonary embolism –– a consequence of long hours traveling in a humvee –– while covering the Iraq war. He experienced pain in his legs but dismissed it.Now she carries on. “Now I want to do my job.” she told NBC news. “Alerting people to the dangers of DVT to the best of my ability.”
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Photo caption: DVT affects up to two million Americans every year. Source: Society for Interventional Radiology.