A team headed by Dr. Ashish Mishra Consultant Interventional Cardiologist saved the life of a 59-year-old woman with massive left leg swelling due to extensive deep Vein Thrombosis. The patient has been discharged from the hospital and is leading a normal life.
Patient Mrs. Vandana Desai (Name Changed), a resident of Virar noticed progressive swelling at left calf and feet associated with soreness in calf and couldn’t carry on with her daily routine since February 2023. For above symptoms, she was hospitalized and evaluated at a local hospital and subsequently found to have left lower limb deep vein thrombosis with involvement up to hip veins (iliac veins).
Deep vein thrombosis (DVT) is a medical condition characterized by the formation of blood clots in deep veins, typically in the legs. It can be caused by trauma, infection, inflammation, or other factors), 2) Abnormal blood flow or 3)Hypercoagulability (genetic or acquired factors such as cancer, pregnancy, hormonal therapy etc) are implicated in patho-physiology of deep vein thrombosis. So, DVT can occur for a variety of reasons, including prolonged immobilization, surgery, injury, pregnancy, hormone therapy, cancer, and certain genetic or anatomical disorders. The clot obstructs blood flow, causing swelling, pain, and potentially serious complications if the clot dislodges and travels to the lungs (pulmonary embolism).The symptoms of DVT include pain, swelling, warmth, and redness in the affected area. However, some people with DVT may not experience any symptoms. The diagnosis of DVT typically involves imaging tests such as ultrasound, CT scan and the treatment usually involves anticoagulant medications (blood thinners) to prevent the clot from growing or breaking off and traveling to the lungs. In some cases, mechanical interventions such as thrombectomy, catheter directed thrombolysis or placement of a filter in the inferior vena cava may be necessary.
Dr. Ashish Mishra, Consultant Interventional Cardiologist said, “On arrival in emergency room, the swelling at left leg had extended till left groin and it threatened viability of left leg due to early compartment syndrome denoting alarming state. The echocardiography was suggestive of normal heart functions with mild pulmonary hypertension. The patient underwent successful complex DVT intervention in the form of 1) Mechanical Thrombectomy (clot removal with specialized catheter system) and 2) PTA-Percutaneous Transluminal Angioplasty (a procedure to open up a blocked blood vessel using a balloon mounted catheter) with adjunct 3) CDT- Catheter Directed Thrombolysis (catheter-based lysis of residual clots with continuous infusion of thrombolytic agent) with Alteplase over 36 hours. The total procedural time for this DVT intervention was 130 minutes. The swelling on the left lower limb resolved more than 50% over the next 3 days of hospitalization and the patient was discharged in clinically improved condition with oral anticoagulation and supportive therapy.
“I was having swelling in the leg which made it difficult for me to walk, stand or even sit. I was dependent on my family members for even doing a basic activity like getting up or sitting down. I was appalled to hear about extensive DVT with a rare congenital anatomical disorder related to veins. I thank Dr. Ashish Mishra and the entire team at Wockhardt Hospitals, Mira Road for saving my life. I have recovered and started doing my daily chores with ease,” concluded the patient.
