Vascular surgeon skilled at treating deep vein thrombosis
Billions of dollars are spent each year in the U.S. to treat deep vein thrombosis (DVT) and post thrombotic syndrome. Vascular surgeon Mireille Astrid Moise, MD, has seen the painful results of these ailments on patients of all ages.
“Post thrombotic syndrome is incredibly disabling and not treating it can lead to major quality-of-life issues,” including swelling to the point of not being able to wear shoes, severe pain while walking and ulcers in the affected part of the body, says Dr. Moise, part of MetroHealth’s vascular surgery team.
The damage done to veins and valves is irreversible.
One of her patients misses one day of work each week to come into the office for treatment of venous stasis ulcers. Thankfully, says Dr. Moise, the patient’s employer has made accommodations which have allowed the patient to continue working.
Other people aren’t so lucky.
According to a 2004 study in in the Archives of Internal Medicine, nearly 90 percent of patients are unable to work due to leg symptoms 10 years after diagnosis of iliofemoral DVT.
Dr. Moise says that for the right patient with DVTs, using a catheter to deliver lytic therapy produces fast results and little, if any, long-term damage to the vein. Thrombolytic therapy has been shown in a number of studies to significantly reduce the incidence of post thrombotic syndrome.
“I had a patient who was swollen from the hip to the toes on one leg. Two hours after the catheter procedure, that patient was up and walking around in recovery,” she says.
The catheter-based procedure is not appropriate for every patient with an ilio-femoral DVT. Dr. Moise says candidates can’t have had a recent stroke, surgery or bleeding and they should have a life expectancy of more than two years.
Dr. Moise works closely with referring physicians before, during and after catheter-based procedures, noting that the catheter procedure isn’t the end of treatment. Patients need to be on anticoagulation therapy for three to six months to prevent recurrence.
There are about 30 identified risk factors for developing DVT. Many of them are unprovoked. Risk factors include:
- Injury to a vein, often a result of fracture, surgery or a severe muscle injury
- Sedentary lifestyle or prolonged immobilization
- Pregnancy and six weeks post-partum
- Chronic medical conditions including heart, lung and inflammatory bowel disease, cancer and high blood pressure
- Previous or family history of DVT or pulmonary embolism (PE)
Dr. Moise and fellow MetroHealth vascular surgeon Christopher Smith, MD; cardiologist Sanjay Gandhi, MD; and J. Jeffrey Alexander, MD, Director, Division of Vascular Surgery, have extensive experience treating a host of vascular issues, including DVT.
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