点击显示 收起
Jan 29, 2008 -- National Institutes of Health?researchers appear to have found a safe way to dissolve the painful blood clots that swell the legs of people with deep vein thrombosis or DVT.
If you suffer DVT -- a blood clot deep in your leg -- doctors usually can keep it from killing you. But this treatment is incomplete: Doctors cannot make the painful condition go away.
This may soon change, thanks to a major study by Richard Chang, MD, chief of the interventional radiology section of the NIH Clinical Center, and colleagues. Chang's team has been able to make all DVT symptoms go away for 18 of 20 patients who underwent their experimental treatment.
"Eventually this will be a practical, complete treatment. We will be able not only to treat DVT, but to restore venous function in the leg. It will be as though you did not have DVT," Chang tells WebMD.
Does it work? WebMD asked Rebecca McDonald, one of the 20 patients in the Chang study. McDonald was 35 when she suffered a huge DVT after giving birth to her third child.
"My clot ran from my calf to my stomach. It became obvious to my husband and me that I was going to lose my leg," McDonald says. "After the second day of treatment, the swelling started to dissipate. A week later I was walking, and a week after that I was running again."
It's been five years since her treatment. McDonald remains symptom free.
Deep vein thrombosis?is a very serious condition, as pieces of the clot can break off and block blood flow to the lung. These pulmonary embolisms can be fatal. Fortunately, emergency treatment with blood thinners -- anticoagulants such as Coumadin -- greatly reduces the chance that this will happen.
But anticoagulants don't go to the heart of the problem. They do not remove the blood clots that plug small veins in the leg. The body may eventually dissolve these clots by itself, but not in time to prevent permanent damage to the delicate structure of the vein.
Interventional radiologists sometimes use infusions of clot-busting drugs such as tPA to dissolve DVT clots. Patients who receive these continuous infusions of clot-dissolving drugs are at high risk of dangerous bleeding in the brain and in other organs.
To avoid this problem, Chang and colleagues apply tiny doses of tPA directly to the clot. None of the study's 20 patients suffered bleeding.
"The beauty of tPA is it is cleared in five minutes by the liver, so any excess is quickly removed. The tPA we put into the clot stays on the clot and continues to work. So we reduce the duration of time the circulation is exposed to these enzymes," Chang says.