New Clot-Busting Procedure Saves Woman's Life

December 23, 2020

It was a typical Independence Day for 20-year-old Alyssa Lee. She was enjoying the holiday at a family cookout when she noticed a persistent backache.

“I was on my period so I figured it was normal cramps,” she said. “But a few days passed and my back continued to get worse. Then my thighs started to hurt as well.”

With all the body aches, she feared she could have COVID-19. She went to a Mercy clinic in Rogers for the test, but it was negative. In the meantime, the pain was spreading.

“Walking up and down the stairs in my apartment was impossible without bursting into tears,” she remembered. “I noticed I had some bruised looking veins on my lower right abdomen. My legs had started to look swollen and red, so I went back to the clinic.”

With one look at Lee’s condition, the doctor immediately sent her to the emergency room. An MRI and ultrasound revealed the problem: a large volume of blood clots throughout her legs and stomach. Doctors started her on blood thinners immediately, and transferred her to Mercy Hospital Springfield, where vascular surgeon Dr. Christopher Stout was standing by.

Indigo-Clot-Monitor Courtesy: The Indigo® System Lightning™ 12 powered by the Penumbra ENGINE™. A doctor looks at images of a clot.

“We determined Alyssa has a rare genetic disorder, called Factor V Leiden, which makes her blood prone to clotting,” he said. “That, combined with a medication she was taking, led to severe clotting throughout her body. She had a particularly concerning major clot in her inferior vena cava in her stomach area going down into both legs. The inferior vena cava sends blood back to the heart from the legs and abdominal organs. Her body had managed to reroute her blood to get it to the heart for oxygenation, but we clearly needed to get everything flowing smoothly again, and quickly. We had to prevent a major circulation blockage to the heart and lungs and open the outflow of the legs to prevent major complications like amputation.”

As one of the most experienced and cutting-edge vascular surgeons in the region, Dr. Stout had access to a brand-new device: The Indigo® System Lightning™ 12, powered by the Penumbra ENGINE™. It requires no cutting or large incisions.

“It’s a minimally-invasive system that works to basically vacuum out clots while leaving as much of the healthy blood in place as possible,” Dr. Stout explained. “It senses and changes the pressure based on whether it’s encountering regular blood or a thickened mass.”

Indigo-Clot-Animation Courtesy: The Indigo® System Lightning™ 12, powered by the Penumbra ENGINE™. This animation shows how the system finds and removes a clot.

With a lot of clots to clear, Dr. Stout worked on Lee for about an hour using the new technology. “It would have taken us hours with open surgery or other devices,” he said.

Lee says recovery was easy. “I had to wear leg braces for a day after surgery to keep me from moving my legs, but once those were off, the only sign anything was even done to me was two small holes behind each of my knees.”

With the clots removed, what had been a scary and dangerous diagnosis was quickly resolved. “I walked out of the hospital the next day with my parents, pain free and headed home.”

Lee continues to take blood thinners to keep the problem from recurring, and that’s caused her to be a little more careful these days. “I have to be careful not to hurt myself, so when I longboard or roller skate, I always wear a helmet and pads.”

A follow-up ultrasound in August showed Lee was still clot-free. “It was so nice to see Dr. Stout and thank him,” Lee said. “He was so calm and gentle and I’m glad he was the one to do my surgery. I wish I knew all the names of the hospital staff who helped me, from the nurses to the ambulance workers to the blood techs at both Rogers and Springfield. They all made me feel safe and cared for.”

While Lee’s condition is rare, knowing the new technology will work on such a complicated case makes it even more promising for those with more common clots such as deep venous thrombosis in the legs or pulmonary embolism in the lungs.

“We can now quickly and safely remove clots that cause DVT/PE and other disorders using a minimally invasive technique,” Dr. Stout said. “Not only will this help many patients with urgent and emergent conditions, it will also broaden our treatment of clot to prevent long-term complications of leg swelling, leg fatigue or chronic pain, and ‘tree trunk legs’ in patients with DVT. Best of all, unlike before, we can minimize hospital stays and in this day of COVID this is beneficial for everyone.”

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