MedStar Health, the Region's Leader in Catheter-Based Pulmonary Embolectomy Performs 100th Lifesaving Case in Baltimore

Procedure spotlights Blood Clot Awareness Month

BALTIMORE – Raghuveer Vallabhaneni MD, Regional Director of Vascular Surgery for MedStar Health in Baltimore, performed the region’s 100th catheter-based pulmonary embolectomy procedure March 5th. It’s the newest available treatment for removing massive, life-threatening blood clots from a patient’s lungs, without opening the chest. The minimally invasive procedure took 30-minutes, and the patient went home the next day.

What is a pulmonary embolism?

Pulmonary embolisms (PE) form when blood congeals in a deep vessel, usually in the leg, and becomes a clot. It travels in the bloodstream to the lung and becomes trapped in a smaller artery. These clots are the third leading cause of cardiovascular death in the U.S., behind heart attacks and stroke, and account for around 100,000 deaths each year.

Historically, pulmonary embolisms are medically treated with just blood thinners (anti-coagulants) and relied on our bodies ability to break down clot which could take months. Meanwhile, the heart is strained by the blockage, and the patient remains at risk for worsening. Clot-busting medications (thrombolytics) are also used for unstable patients, but these medications have the possibility of causing potentially life-threatening bleeding complications.

A patient with a PE emergency

Paul Saunders knew he was in trouble when he arrived at the emergency department at MedStar Harbor Hospital. His heart rate was very high. He was sweating, feeling faint, and having such difficulty breathing, he couldn’t speak.

“A PE was immediately suspected,” said MedStar Health Vascular Surgeon Jason Chin, MD, “so we called for our multi-disciplinary Pulmonary Embolism Response Team (PERT). He was evaluated, received a full work-up and CT scan. The diagnosis was confirmed and because he needed more immediate treatment than just blood thinners, he was transported to MedStar Union Memorial for care. Everything happened in the span of a few hours.”

Fast removal of the blood clot without open surgery

In the vascular lab at MedStar Union Memorial, with the patient under local anesthetic only, Dr. Vallabhaneni accessed the clogged vessel by inserting a catheter into the femoral vein though a small nick in the groin. Using a suction device at the end of the catheter, he was able to aspirate the clot out of the blood vessel. He repeated this multiple times to resume normal blood flow. The whole procedure took about 30 minutes.

In recovery, Sanders’ heart rate went from 123 before the procedure to 100. Six liters of oxygen was needed prior to the procedure to keep his oxygen saturation at 94%, but after, he was breathing room air at 99% saturation. His lung artery pressure was back to normal and the patient was discharged by lunchtime the next day.

“Without the catheter technology, Paul would still be in the hospital, with persistent shortness of breath,” Dr. Vallabhaneni said. “This has been a life-changing therapy for so many of our patients, safely removing clots that impact their breathing, improving their quality of life, reducing their hospital stay, and potentially preventing further strain on their hearts that may lead to heart failure.

“What worked well was the rapid and seamless evaluation, diagnosis, transfer and embolectomy for this patient,” Dr. Chin added.

According to the CDC, blood clots or known as deep vein thrombosis (DVT) affect 900,000 people each year and are often underdiagnosed. They can affect anyone and can lead to serious illness, disability, and death.