When a patient develops a “clot’ in an artery or a vein, that is a medical emergency. An example of this is shown in figure 1 where you see the dark image of the contrast coming to an abrupt halt. The patients left foot was ice cold and painful. There were no pulses felt in the foot. The foot was dusky and purple.
After using a clot busting medication the artery and adjacent graft that is supplying flow to that leg is now open (figure 2).
However, at the origin of the graft there is a residual clot and blockage either from scar tissue or plaque. (Figure 3).
At this time the decision was made to take the patient to the operating room to “clean” up the rest of the artery. The plan was to manually remove the clot and then “cut” out (endarterectomy) the plaque that was narrowing the artery. (figure 3 and 4).
After this combined and collaborative approach to the treatment of a very complex patient, the patients foot was warm to the touch, had normal pulses re-established, and the foot was once again PINK! Advances in treatments for patients with blood clots has allowed physicians the tools to change the outcomes for this emergent medical condition.