Deep vein thrombosis or DVT affects more than 1 million Indians every year, and the complications, such as pulmonary embolism, migration of loose clots to the lungs, etc., can be life-threatening. This clotting of small and large blood vessels is increasing since the appearance of the thrombogenic Covid-19 virus. In a sense, DVT is cancer of the veins, which slowly but surely affects blood flow and has the ability to cause persistent pain and ulcers in the legs, leading to a drastic decrease in a person’s quality of life.
DVT is the formation of blood clots in the veins of our body, most commonly the calf and thigh veins. Because these calf veins eventually open into the heart and lungs, a clot in these veins can easily dislodge and migrate to these vital structures, causing life-threatening complications such as pulmonary embolism by blocking blood flow to the lungs.
The symptoms of DVT include leg swelling, cramping pain, changes in skin color, and a feeling of warmth on the affected leg. Warning signs may include sudden shortness of breath, dizziness, fainting, palpitations, coughing up blood, and severe leg swelling, requiring immediate rush to hospital.
Although the disease is serious, the solution is simple enough. The treatment of DVT is an early procedure of thrombolysis to remove clots. With the advancement of medical technology and expertise, today most procedures can be performed through a small puncture without any surgery. To prevent the migration of dislodged clots to the lungs, a specialized inferior vena cava (IVC) filter is inserted into the main vein of the abdomen.
The Endovascular Live event, or EVL 6.0, has been organized in New Delhi to discuss this crucial issue. EVL is a global platform with 13 national and international centers with more than 350 vascular specialists participating from major cities across India including tier-2 and tier-3, Nepal, Bangladesh and West Asian countries for mutual learning through live demonstration cases performed by highly trained endovascular specialists.
This time, the 3-day EVL began on Thursday, with the theme of clot management – how to treat a venous clot (DVT) and how to clot (embolize) a bleeding vessel.
dr. VS Bedi, Chair of the Vascular Surgery Department at Sir Ganga Ram Hospital, and Chair of the EVL Organizing Committee, explained how coagulation management is a pressing issue in today’s rapidly changing post-pandemic world.
These blood vessels must be occluded by the micro-puncture embolization procedure and the use of specialized materials such as gelatin/PVA particles/sclerosant and coils, avoiding major surgery.
Such embolization of the blood supply to the cancerous mass not only speeds up treatment, but also makes certain stubborn cancers treatable, giving new hope to those afflicted with the terrible disease.
This highly refined treatment requires tremendous skills that were not readily available a few years ago, except in a few centers of excellence in major metro cities. Over the years, EVL has shown multiple cases of different types of thrombosis and embolization that have helped to improve the skills of endovascular experts through sophisticated discussions about each step of the procedure and sharing valuable insights through the legends of endovascular interventions, that in turn has made such advanced treatments available in tier-2 and tier-3 cities by training interventionalists across India.
When asked if this dangerous clot is anyone’s nemesis, Dr. Ajay Yadav with a wry smile: “Cagulation in normal blood vessels is a problem, but abnormal blood vessels actually require clotting as a treatment. It is a necessary devil.”
These abnormal blood vessels can be an underlying cause from a small bump on the forehead to a huge tumor in the abdomen. The malformed blood vessels in the uterus can cause pregnancy loss and heavy bleeding.
With a special Fellows course in the EVL program, young and experienced vascular surgeons observe the stalwarts of the field, resulting in a highly skilled and confident young crop of endovascular experts.
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