Busting Blood Clots

Last summer, Judge John Fader was hospitalized at St. Joseph Medical Center with a blood clot in his leg following a bad virus.

A week of traditional treatment with blood thinners to dissolve the clot was not working, so Fader’s physician requested that vascular surgeon Dr. Wayne Reichman consult on the case. Reichman used the Trellis system, a new medical device, to dissolve and vacuum out the blood clot — also known as a deep vein thrombosis (DVT).

“I was very lucky. He saved my life,” says Fader about Reichman. “I was in a lot of pain. My left leg was swollen to twice its normal size.

“This was a brand new procedure. Thanks to it, I didn’t have to keep worrying about when the clot was going to dissolve and if it was going to kill me.” One frightening risk of a blood clot is that it can break off and travel to the lungs or heart, which can be fatal.

Now, the Trellis has made the pain, swelling and life-threatening danger of a blood clot in the leg a thing of the past.

According to Reichman, “It used to be patients with DVTs were traditionally treated with Heparin in the hospital or as outpatients with Lovenox followed by several months of Coumadin.”

Unfortunately DVTs treated this way result in permanent damage to the leg valve that channels blood flow back to the heart, causing significant leg swelling. Patients needed to wear elastic stockings for life to help prevent recurrent DVTs, as well as skins ulcers and breakdown.

In the 1980s and 90s, clot-busting drugs, such as tPA, were a breakthrough for dissolving blood clots, explains Reichman, but had risks of causing serious bleeding elsewhere in the body and required an intensive care hospital stay.

The Trellis uses tPA but confines it to the area where the clot is lodged in the leg. Named after its shape — a long curved wire structure — the Trellis is inserted directly into the clot.

“The Trellis features two small balloons that are inflated to form a barricade on each side of the clot so the tPA does not get released into the body’s circulation,” says Reichman. “The wire is oscillated back and forth to better disperse the drug and breakdown the clot quickly.” After the procedure, both the drug and the clot are sucked out, and the wire is removed.

The vein opens right away, and the patient can be discharged soon after. “I went home that night, and I immediately went back to work,” attests Fader, who teaches at the University of Maryland School of Law. “The whole treatment was absolutely fantastic.”