Ultrasonic Delivery

New technique quickly dissolves blood clots in the lungs.

Thursday, October 26 started out like a typical day for Victor Russo*. That morning, he had a dentist appointment for a routine cleaning and came home feeling fine. Later, his son asked him for help installing a toilet. Victor was willing as usual to lend a hand, but as the afternoon and evening wore on, his day began to unravel. It turned into 24 hours he would never forget.Stock photo from istockphoto.com.
“As I was bending over working on the toilet, my breathing became labored,” describes the 64-year-old Bronx, New York native. “I didn’t think much of it, but later on, my breathing got worse. It soon felt like I had a bag over my head and I was suffocating.
“My heart was also racing, but I didn’t want to go to the hospital. Then it became Friday morning around four o’clock. I finally told my wife to call 911. The EMS team calmed me down and helped me breathe a little better, but my heart was still beating very fast. They transported me to Lakewood Ranch Medical Center.”
It was close to 4:30 a.m. when Victor was wheeled into the emergency room at Lakewood Ranch Medical Center. Straightaway, the ER staff began evaluating his symptoms, running tests and ordering scans. Eventually, a picture of Victor’s health became clear.
There were blood clots in Victor’s lungs, and it was causing a severe strain on his heart. The ER staff immediately contacted the cardiologist on call, Vivek Kumar, DO.
“When Dr. Kumar came in, he explained that I was a candidate for a new procedure to dissolve the clots,” relates Victor. “Dr. Kumar is one of only a few doctors who can perform the procedure.”
Victor agreed to the intervention, called EKOS™ Acoustic Pulse Thrombolysis™, and at approximately 10 a.m., he was moved from the emergency room to the hospital’s cardiac catheterization lab. There,
Dr. Kumar performed the delicate technique that may have saved Victor’s life.
“Victor came into our ER with shortness of breath, and the attending doctor initially thought he had pneumonia or something similar,” reports Dr. Kumar. “However, a CT scan with contrast revealed the rather extensive clots in both lungs, a life-threatening condition.
“We had recently obtained a new device at Lakewood Ranch Medical Center for dissolving clots using ultrasonic energy. EKOS is the name of the device manufacturer. The technique goes through the veins to deliver the ultrasonic waves as well as medication to the clot.”
“I don’t have any idea how long the procedure took, but I do know I got to my room in the ICU at eleven fifteen that morning,” notes Victor.

Good Vibrations

During Victor’s EKOS intervention, Dr. Kumar inserted two tiny catheters into a vein in Victor’s groin. The doctor then advanced the catheters through Victor’s venous system into his heart, then into his lungs, one catheter to the left lung and one to the right.

Graphic courtesy of EKOS.

EKOS – The EkoSonic® Endovascular System
with Rapid Pulse™ Modulation –
the vibration of the ultrasonic filaments allows the medicine to penetrate deep into the clots to more quickly and effectively dissolve them.

“We use catheters with special ultrasonic filaments in them,” explains Dr. Kumar. “The filaments vibrate in such a way that they enable clot-busting medication to run through the catheters and into the clots. We typically use a medication called tissue plasminogen activator, or tPA.
“With this technology, we are able to treat the clots using less tPA, which can, in higher doses, lead to bleeding elsewhere in the body, including the brain. The EKOS technique virtually eliminates bleeding complications. In addition, the vibration of the ultrasonic filaments allows the medicine to penetrate deep into the clots to more quickly and effectively dissolve them.”
Dr. Kumar points out that with traditional IV administration of tPA, patients remain in the hospital for up to a week and a half. Following his EKOS Acoustic Pulse Thrombolysis, Victor was released in three days.
“Victor recovered much more quickly following the EKOS intervention than he may have with traditional therapy,” verifies Dr. Kumar. “His symptoms started improving two hours after the thrombolysis. He went to the ICU on high-dose oxygen, but was completely free of oxygen by the end of the following day.”
“I was awake during the procedure, but I didn’t feel anything,” shares Victor. “I was lying on the table, and I could hear everything Dr. Kumar and the staff were saying and doing to me. They placed a probe through my groin and positioned it to break up the clots.
“I felt immediate relief once the procedure was over. I started breathing better right away, but it wasn’t entirely like it used to be. I still needed oxygen. It took a few days for my heart rate to calm down and my breathing to really improve.”

Better Days

Victor shares that he had no pain during or after the EKOS intervention. It was necessary for Dr. Kumar to leave a tube in Victor’s leg where the catheter was inserted. The tube was removed two days later, and he says even that didn’t hurt. Victor was discharged from the hospital on October 30, 2017, and his recovery is still progressing.

“The fortunate thing is the EKOS procedure was available for me right then and there at Lakewood Ranch Medical Center.” – Victor

“My breathing is not back to full capacity yet, but I feel a lot better,” he reports. “When I first got out of the hospital, I couldn’t walk two steps without breathing heavily. Now, I can walk and get around okay. By six o’clock this morning, I’d already walked the dog, and my breathing was fine.
“Since the procedure, I’m one hundred percent better.”
The results of the EKOS Acoustic Pulse Thrombolysis have Victor feeling like a new man, and the staff at Lakewood Ranch Medical Center made him feel like the center of attention. He’s very pleased with the care he received while he was a patient at the hospital.
“The treatment I received from the nurses and staff in the ICU was fantastic,” he acknowledges. “Before I even got there, the nurses found out I had back problems and got me a special bed for my back, which helped.
“I can’t say enough about the nurses who took care of me, because I was bedridden for three days. The things they had to do for me were unbelievable. I couldn’t ask for better care than I got at Lakewood Ranch.”
For Victor, that day in October turned into a fight for his life. With some luck and a lot of help from Dr. Kumar and the staff at Lakewood Ranch Medical Center, he was able to win the fight.

“Since the procedure, I’m one hundred percent better.” – Victor

“When all those problems started happening, I thought I was on death’s door,” he states. “My mistake was letting it go so long. It was my wife who insisted I go to the hospital. The fortunate thing is the EKOS procedure was available for me right then and there at Lakewood Ranch Medical Center.”

*Patient name withheld at their request.
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