CLOT BUST­ING

ZOOMER Magazine - - MIND - By Dr. Zachary Levine Dr. Zachary Levine is an as­sis­tant pro­fes­sor in the fac­ulty of medicine at McGill Univer­sity Health Cen­tre and med­i­cal cor­re­spon­dent for AM740 (a ZoomerMe­dia prop­erty).

BLOOD CLOTS ARE ES­SEN­TIAL to save us from bleed­ing to death, but when they end up in the wrong place – es­sen­tially block­ing the pas­sage of blood to an area of the body where it’s needed – the area is starved of es­sen­tial oxy­gen and nu­tri­ents and be­gins to die. They can be deadly, caus­ing heart at­tack (where heart mus­cle dies), stroke (where brain tis­sue dies), pul­monary em­bo­lus (a blood clot in the lungs wherein lung tis­sue dies) and is­chemic limb (a blood clot to a limb).

An ex­cit­ing de­vel­op­ment in treat­ment of these lifethreat­en­ing blood clots is throm­bol­y­sis, or clot busters. These are med­i­ca­tions that dis­solve blood clots rapidly, restor­ing es­sen­tial blood sup­ply and min­i­miz­ing per­ma­nent dam­age or death. They can be given sys­tem­i­cally, or through­out the body; in some cases, they can be de­liv­ered di­rectly to the blood clot, lim­it­ing the risk of bleed­ing. Throm­bolytic med­i­ca­tions are very pow­er­ful and do carry the risk of caus­ing se­ri­ous bleed­ing else­where, so they are only given in life- or limb-threat­en­ing sit­u­a­tions. For ex­am­ple, when the med­i­ca­tion is given soon af­ter the on­set of symp­toms. The med­i­ca­tion can­not be safely given if some­one has had re­cent surgery or in­jury that is sus­cep­ti­ble to bleed­ing.

An­other devel­op­ing treat­ment is thrombec­tomy – the re­moval of the blood clot by use of a net or bas­ket or suc­tion within the blood ves­sel. This has the ad­van­tage of di­rectly ad­dress­ing the prob­lem at its source. But this is an in­va­sive pro­ce­dure, and there are risks (bleed­ing, dam­age to the blood ves­sel, in­fec­tion). Again, the ben­e­fits must out­weigh the risks, which is of­ten the case when life or limb is on the line.

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