Deep vein thrombosis or DVT affects more than 1 million Indians every year, and its complications like pulmonary embolism, migration of loose clots into lungs, etc, can be life-threatening. This clotting of small and large blood vessels has been on the rise since the appearance of the thrombogenic Covid-19 virus. DVT, in a way, is cancer of the veins, affecting the blood flow slowly but surely and has the capacity to cause persistent pain and ulcers in the legs, leading to a drastic decline in a person’s quality of life.
DVT is the blood clot formation in the veins of our body, usually the calf and thigh veins. Because these calf veins ultimately drain into the heart and lungs, a clot in these veins can easily loosen up and migrate to these vital structures, causing life-threatening complications like pulmonary embolism by blocking the blood flow to the lungs.
The symptoms of DVT are leg swelling, cramping pain, changes in the colour of the skin, and a feeling of warmth on the affected leg. Warning signs can be sudden shortness of breath, feeling of dizziness, fainting, palpitations, coughing up blood, and severe swelling of the leg, where one needs to rush to the hospital immediately.
Though the disease is grave, the solution is simple enough.
The treatment of DVT is an early procedure of thrombolysis for the removal of clots. With the advancement of medical technology and expertise, today most of the procedures can be performed by a small puncture without any surgery. To prevent the migration of loosened clots to the lungs, a specialised inferior vena cava (IVC) filter is inserted in the main vein of the abdomen.
The event Endovascular Live, i.e., EVL 6.0, has been organised in New Delhi to discuss this crucial issue. EVL is a global platform with 13 national and international centres involving more than 350 vascular specialists participating from major cities across India, including tier-2 and tier-3 ones, Nepal, Bangladesh, and West Asian countries for mutual learning via demonstration of live cases being performed by highly skilled endovascular specialists.
This time, the 3-day-long EVL started on Thursday, with the theme of clot management – how to treat a venous clot (DVT) and how to clot (embolise) a bleeding blood vessel.
Dr VS Bedi, chairman of the vascular surgery department at Sir Ganga Ram Hospital, and chairman of the organising committee of EVL, explained how clot management is a pressing issue in today’s fast-moving post-pandemic world.
These blood vessels need to be clotted by the procedure of embolisation via a micro-puncture and the use of specialised materials like gelatine/PVA particles/sclerosants, and coils, thus avoiding major surgery.
Such embolisation of blood flow to the cancer mass not only expedites the treatment but it makes certain stubborn cancers treatable, bringing new hope for people suffering from the terrible illness.
This highly refined treatment requires immense skills that were not easily available a few years ago except for at some excellence centres in major metro cities. Over the years, EVL has showcased multiple cases of various types of thrombosis and embolisation contributing to the advancement of skills of endovascular experts through refined discussions on each and every step of the procedure and sharing of valuable insights by the legends of endovascular interventions, which in turn has made sure that such advanced treatments are available in tier-2 and tier-3 cities by training of interventionalists across India.
When asked if this dangerous clot is a person’s nemesis, Dr Ajay Yadav replied with a wry smile: “Clotting 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 of a small bump on one’s forehead to a huge tumour in one’s abdomen. The malformed blood vessels in the uterus have the potential to cause loss of pregnancy and heavy bleeding.
With a special Fellows Course in the EVL programme, young vascular surgeons observe and experience the stalwarts of the field, which has led to a highly skilled and confident young crop of endovascular experts.