Dr. Mark J. Garcia Presents Promising Treatment for Chronic Deep Vein Thrombosis
VEITHsymposium 2009: Dr. Mark J. Garcia Presents Promising Treatment for Chronic Deep Vein Thrombosis
by Andrea B. Epstein
This year’s veiTHsymposium, now
in its fourth decade, provided vascular
surgeons, interventional radiologists,
interventional cardiologists and other
vascular specialists with a five-day
program in november focused on
bringing to the forefront advances in
diagnosis, management and treatment of vascular disease.
Among the ?00 rapid-fire presentations from renowned
vascular specialists was a presentation of particular interest
to vein readers, by Dr. Mark J. Garcia, Program Director,
vascular & interventional Radiology Fellowship and Section
Chief, vascular & interventional Radiology at Cristiana Care
Health Services in newark, Delaware. The topic: a promising
new treatment for chronic deep vein thrombosis (DvT).
in his presentation, Dr. Garcia shared the results from a
study of 50 patients with chronic, hard and occlusive DvT
suffering from Post Thrombotic Syndrome (PTS). According
to Dr. Garcia, “when the thrombus injures or destroys the
deep venous valves, chronic venous insufficiency (Cvi) can
occur. The symptoms associated with Cvi are called Post
Thrombotic Syndrome and include the spectrum ranging
from extremity heaviness or fatigue, swelling and pain,
itching, cramps and paresthesia (“pins and needles”). Signs
of PTS include edema, redness, hyperpigmentation, varicose
veins, dependent cyanosis, peri-malleolar telangiectasia,
subcutaneous fibrosis, venous stasis ulcers and more rarely
gangrene and amputation.”
PTS is the most common complication of venous
thromboembolism (vTe) and has been shown to cause a
significant reduction in quality of life for patients, leading to
repeated hospitalizations and long-term treatments. Many
sufferers can no longer function as productive members
of the workforce, adding an additional economic burden
beyond the cost of medical care.
Findings from the 50 patient study showed that the
patients with chronic DvT and PTS were successfully treated
with endovascular techniques to restore flow and reduce
the symptoms related to PTS. Dr Garcia noted, “The eKOS
ultrasound assisted thrombolysis, in addition to standard
angioplasty and stenting techniques, led to successful venous
recanalization patency with improved venous outflow. Our
results suggest that the ability to successfully recanalize
chronically occluded venous segments in patient with PTS,
benefit the patient by reducing their symptoms and allowing
them to enjoy an improved quality of life.”
in terms of the broader ramifications of this initial study,
Dr. Garcia believes they may be far-reaching. His message
at veiTH was two-fold: First, the medical community needs
to be made aware that there is an opportunity to make a
significant difference in the lives of patients with DvT. And
secondly, the public needs to be informed that for those
with chronic, hard DvT, there are now potential treatments
that can improve their condition.
Further, Garcia is starting to quantify the potential cost
savings from allowing individuals with PTS to resume normal
activity and gain day-to-day productivity in their lives.
He believes that the successful treatment of this chronic
condition can have significant financial benefits to the health
care system. He estimates that the economic burden of PTS
may be upwards of $2 billion.
while Dr. Garcia recognizes that the results from this
small sample of chronic DvT patients is very powerful, he is
also looking at the future, in terms of collecting more data,
verifying his results over a broader patient based and further
improving patient outcomes for chronic DvT. Questions that
he hopes to address include: Have we made a difference over
the longer term, and are these improved results sustainable?
what are the best tools and drugs available to achieve the
optimal long term outcome for chronic DvT patients? And
finally, what are the true cost savings in terms of reduced
patient side effects, better quality of life, less office visits,
and improved workforce productivity?
Ultimately, Dr. Garcia notes this presentation is the start
of a broader education campaign. “we want to increase both
the public and medical community awareness that there are
treatment options for chronic DvT—patients no longer just
have to live with it.”