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New innovative system used for the first time to treat pulmonary embolisms at the Medical Center - University of Freiburg

If a blood clot jeopardizes the work of the lungs and thus the oxygen supply, quick help is needed. Pulmonary embolisms are one of the most common causes of death from cardiovascular diseases and are often difficult to treat. In June, the Department of Cardiology and Angiology at the Medical Center - University of Freiburg used a new procedure to remove such a blood clot for the first time at the Bad Krozingen campus - with success: the patient was able to return home after a few days.

When dilution is not the solution

In most cases, medication is used to treat pulmonary embolisms, which is administered via a drug pump over a period of around ten hours to dissolve the clot. However, this lysis therapy inhibits blood clotting, which can increase the risk of internal bleeding.

"Our patient had already experienced internal bleeding before the pulmonary embolism, so it was out of the question to dissolve her blood clot with anticoagulant drugs," reports Dr. Elias Noory, Senior Consultant in the Department of Cardiology and Angiology at the Medical Center - University of Freiburg. "Taking current studies into account, we then decided to remove the clot mechanically using a catheter."

Rapid intervention brings immediate improvement

With the new system, a flexible, approximately eight-millimetre-thin tube is advanced via the inguinal vein through the heart into the pulmonary artery using a catheter under local anaesthetic. Extreme caution is required to avoid damaging the sensitive structures. X-rays are used to check whether the tube has reached the clot precisely; the physicians then use a wire mesh to pull the clot into the catheter, while possible fragments are sucked in directly on site. "Immediately after removing the clot, we were able to observe how the oxygen saturation in our patient's blood increased significantly," says Noory. "Towards the end of the treatment, she reported that she was breathing much better." She was able to be transferred to a normal ward just a few hours after the procedure and was discharged home a few days later.

The pivotal study in the USA showed that around two thirds of the patients examined did not have to spend another night in the intensive care unit after the procedure. On average, they were able to return home after three days. "Especially for patients with blood clotting disorders, it is of great value to be able to offer a minimally invasive procedure for removing blood clots with thrombectomy," says Prof. Dr. Dirk Westermann, Medical Director of the Department of Cardiology and Angiology at the Medical Center - University of Freiburg.