DawgTalkers.net Forums DawgTalk Tailgate Forum Blood Clot

The wife and I went to the Dr's yesterday to see a Vascular surgeon and they found a blood clot in her thigh, and from what I understand the doctor is going to do an angioplasty on the artery in her thigh, I understand the procedure but am curious if anyone has had a similar procedure or know of someone who has and what is the recovery time once the procedure is done? There is a slim chance she can lose her leg if this is not corrected but it looks like they caught it early since the doctor considers losing the leg less than 1%. Anyways if anyone has any personal knowledge about this surgery please advise, I've done the internet search and have the basics, I am curious about others personal knowledge.

Thanks.

I don't know anyone that has personally dealt with this, but wanted to wish you both the best and I'm glad that it was caught early. What were her symptoms that she knew something wasn't right?

My sister in law had one in her leg. Her leg swelled up pretty big. They didn't do surgery though, just put her on coumidin (spelling?) after about 2 days in the hospital. (she was pregnant at the time)

She was experiencing pain in the calf and foot, then they did an ultrasound, and another test and couldn't find a pulse in her foot, this was going on for roughly 2 months and after 6 different doctors they finally referred her to someone with a clue. The clot is in a major artery and is too big for med's. What really sucks is right after this she is going to have to have a hysterectomy because of 2 very large tumors in her uterus.

Sorry you guys are going through all of this. Please give her my best.

Please tell her we are thinking about her and hoping for the very best.

Thanks I'll pass that to her. We are just happy we know what is going on now, the foot issue needs to be taken care of first, but the hysterectomy is second. The tumors are non cancerous thank goodness, but when her woman issue's happen, she brings a new meaning to the phrase PMS due to the amount of pain she is in, and she has to have all this done before next September before she retires but hopefully nothing else crazy happens between now and then.

Glad to hear they finaly sent her to someone that could diagose the problem before something far more major occured. But I fully understand that surgery is a scary thing.

Please send her my best and let her know she's in my thoughts and prayers as you are as well.

I'm not sure where a friend of mines blockage was, but he had that procedure, spent 3 days in the hospital, was a little weak when they brought him home but was pretty much up and around and back to normal within a week.

All my best to your wife...

Shouldn't be all that bad. This happened to another Dawg's realative a few years back. I was a special procedures tech and a cardiac cath tech for many years, I have been in a good many of these procedures. I'm at work right now, so I'll break it down pretty quick. If you have any questions, I'll check back in later.

Most likely, it will be a baloon angioplasty, they may or may not do some drug therapy prior to the procedure to soften up the clot/plaque. They will give her a pretty mild sedative for the procedure, she will be awake, but between the sedative and the local, it is generally very well tolerated.

She will have a prep the night before, nothing too tough, but any time we sedate, we like clean insides. It helps with dosing, vommitting and makes the meds more effective. From the patients I speak with from the night before to the morning of is the toughest time. Anticipation, doubt and fear. Doctors have to inform you of every reasonably possible outcome for any procedure. Some of the outcomes have not been realistic in decades, but it's tradition. The fact is, this procedure is doen mayba a million times a day across the country, and I have yet to hear any real nightmare stories or complications. Don't get me wrong, I'm sure they happen, but I honestly cant name any.

The morning of, they will have her put on our high fashion apparel, and get her in a stretcher or perhaps right in the angio suite. She will lay on the procedure table, have all the bells and whistles attached and the Radiologist will speak to her again, usually giving her the exact plan of attack for her specific situation based on the information he/she has. Usually the anxiety begins to relent a little. The staff will be professional and expert at calming her and answering her questions.

The procedure itself is pretty simple. A large, two part needle (usually a seldinger) is inserted into a large vessel in the groin. When it's in place, the core of the needle is removed, and a wire passed into the vessel and down. The needle is removed, leaving the wire in place. The size of the needle and the depth can be uncomfortable, but local anesthetics are liberally applied, and monst places even use NEUT in the antisthetic to ease the sting.

Usually they will look under real time x-ray (fluoroscopy) to make sure things are going to the right spot. When the wire looks good, they pass a small catheter over it, it can cause pressure and discomfort, but generally not pain. The catheter goes down to the suspect area under fluoro. When in place, the wire is removed. Contrast is injected, it can cause a warm sensation and a metallic taste. I have also found that if I tell them it will feel cold, they are likely to feel that. It's really just something people aren't used to feeling, and the metalic taste is from the iohexol (similar to idodine).

They will do all kinds of cool photography stuff and precisely mak the area to be treated. Most of the time, the patient is able to see most of the images if he/she chooses.

After the tech part, the wire is re-inserted and the catheter slides out over it. Some times dialators are used to make a slightly larger opening for the next catheter. This can cause some pain as the skin is stretched. As it gets deeper it can cause an odd pressure sensation. After that, the balloon catheter is fed to the area previously mapped. Most Rads blow it up with a diluted solution of contrast (the iohexol) and saline. This will start to fill the void inside the vessel and clearly show the narrowing caused by the clot. They will slowly inflate the balloon untill a specific pressure is reached.

That's pretty much it. They may futs around a bit to see how much the vessel opened, and may do the balloon again. But it's all downhill from there. They pull everthing out, hold pressure on the groin for a while, maybe put in a stitch or two and you're done. A short recovery time, mostly to make sure the bleeding doesn't start. And most people can go home after.

Good luck with everything, I hope it goes smoothly.

I printed out your response for my wife and she says thanks! One question is about stints, what is there main purpose in this procedure and what constitutes needing a stint compared to not. Last thing what exactly does a stint do in this situation? Does it make the surgery tougher or no real bearing?

Again thank you so much for the info, the Mrs understood your breakdown and it made her feel better! Thanks

I had angioplasty (SP) on both of my legs back in '95. I went into the hospital one early morning, had the proceedure, stayed overnight and went home in the morning. I sat around the house the rest of that day trying to decide how I was really feeling since I didn't notice any real complications. The next day I changed the brakes on my truck as I felt great!

Even with all the getting up and down doing that job it never bothered me.

The incision was less than a 1/2" and it was at my right side low near the hip. It turned black and blue all around the area and looked like a much worse injury than it was. That was probably due to all the digging around the Dr. did while feeding the line into my artery. I was awake throughout the entire proceedure. The only pain I felt was when they were inflating the baloon. They gave me an extra shot of pain killer just before they did it. It was a pretty intense pain. The kind I'm not fond of. But it lasted probably less than a minute, the drug wore off and everything was normal.

The reason I had the proceedure was because my right leg was nearly 90% blocked of blood flow. I'd found myself having to stop and rest on my way out the mailbox. Less than a week after the angioplasty I almost ran everywhere I went including up stairs. That novelty wore off soon enough but I never had the problem again.

All in all, by the third day I felt great and never looked back.

Good luck to your wife and I greatly hope her experience is very much like my own.

Ohh wow man, I am so glad that they found this early enough that it's not gonna do anything severe. Blood clots are serious. That is what killed my sister-in-laws unborn baby last year when it traveled from her leg to the umbilical cord She was on blood thinners for a year and now is pregnant again and has to give herself shots in the belly button each day.

Good luck with everything. Sounds like she has a lot to deal with coming up.

Well, a stent can be one of two things, in this cace, probably a graft of either gore-tex or natural vein. It's more serious than the baloon procedure.

The graft entails opening the site surgically, this would be under general anesthesia. Cutting down to the vessel. Cutting out the effected area and sewing in the stent or graft. It has a very high success rate, but it's used in more serious cases. I was hoping from the sound of it, your wife wasn't that serious. Is the stent a definate or an option?

The procedure is actually probably easier, due to the fact she will be aslepp. The recovery is longer because of the incision and cut down. Still nothing major though.

The other type of stent is mainly for aneurisms. Using the same procedure I mentioned before, they insert the sten instead of the baloon. It is deployed in the area of interest and attaches with tiny hooks. After a period of time, it reduces the pressure outside the aneurism and takes over as the vessel.

Either way, the before part is much harder than the after. The vast majority of my patients post op comments were to the effect of "wow, all that worry for that?". I'm sure she will be fine. The best part is, either procedure is like opening a valve. The blood flows immediately to feed the effected area and start the healing process. It will be like having a new foot.

Unless you married an 85 year old with multiple health problems, recovery is fairly quick.

It's an outpatient procedure where you can go home the same day. Depending what the doctor uses to close up the puncture, it can be anywhere from 2 to 6 hours of bedrest post procedure, then she'll get up and walk around to make sure no bleeding occurs.

Angiplasties/angiograms are done via a puncture in the groin. They access the femoral artery typically from there. Since it's an artery and the pressure is high, they usually have the patient lie in bed for 2-6 hours, depending on what they use to close it with. Since it's an artery and the pressure is much higher, bleeding is the only real risk. The things you want to look for is hematomas (large collection of blood) at the punture site, swelling, or numbness, coolness, or loss of pulse in the leg post op. After that, it's nothing strenuous for several days.

It's not a complicated procedure, and they are done pretty frequently, but as do all surgeries and invasive procedures, there's always a risk.

Hope that answers some questions. I hope everything goes fine for your wife Fletch.

Just for everyone's education. Regarding blood clots in the leg there is a big distinction between a blood clot in a vein and a blood clot in the artery.

A blood clot in the vein is often referred to as a DVT or deep vein thrombosis (if it is in a superficial vein it is not significant - though the superficial femoral vein is actually a deep vein so you can get confused by the names). A DVT usually presents as swelling of one leg. It can be uncomfortable but not typically the severe pain you see with a blood clot in the artery. Treatment for a DVT is typically with blood thinners for a few months sometimes longer depending on the underlying cause of the clot. The biggest risk is for some or all of the clot to break off and travel through the bloodstream to the lungs. This is called a pulmonary embolism or PE. A PE typically presents with chest pain and shortness of breath. Most DVTs do not become PEs especially once blood thinners get started. However if the piece of clot that embolizes to the lung is big enough it can be life threatening.

A blood clot in the artery is typically much more painful than a DVT. Usually patients are started on iv bloodthinners and sometimes this will take care of the problem but many times a more invasive treatment is needed like angioplasty. These clots do not break off and and go to the lung but if severe enough can be limb threatening and if not addressed can result in amputation of the leg.

My wife had a very similar procedure a couple weeks ago.
She had a major plaque blockage in her aorta that was blocking blood flow to both her legs.
She too had no pulse in her legs.
The operation was performed under local anistetic (sp) through a very small incision in her groin.
A stent was installed.
She had to have bed rest for 6 hours and they kept her overnight for observation.
It was a breeze for her...and she is doing so much better.
Her legs feel great again!
The doctors pre op warnings scare you a bit,but it was much worry about nothing.
Good luck to your wife!

I appreciate all the insightful responses and well wishes thanks again for the valuable information.

Sorry to hear about your wife. I hope everthing works out.

I asked the Big Guy upstairs to send some help your way.

No experience here Fletch. Good luck your wife and you though.