University of Florida Affiliate Pioneers Cardiology Treatment

April 2, 1997

MELBOURNE—For the first time in Florida, physicians have the ability to remove blood clots from arteries using a nonsurgical procedure that can help people with a variety of medical conditions.

The procedure, known as aspiration thrombectomy, was performed by physicians at the Health First Heart Institute at Holmes Regional Medical Center in Melbourne, a University of Florida College of Medicine affiliate.

A 68-year-old man from Okeechobee became the first patient to undergo the new therapy, which successfully removed a blood clot from a large vein in his liver.

The clot was destroyed by a high-velocity stream of saline solution administered through a specially designed catheter. The catheter also provides an exit route for the broken-up clot particles to be evacuated from the body.

Dr. Charles Lambert, a UF professor of cardiology and director of the heart institute, and Dr. Thomas Foster, an interventional radiologist, removed the clot Feb. 17 in a brief procedure, avoiding the need for surgery or clot-dissolving drugs.

“This procedure offers new hope for patients who suffer from coronary artery blockage complicated by the formation of clots, and will undoubtedly set the standard for catheter-based treatment of this and related problems for years go come,” Lambert said.

Each year, more than 10 million people worldwide are afflicted with blood-clot conditions, such as heart attacks and stroke.

The Health First Heart Institute is one of 25 sites worldwide — and the only hospital in Florida — selected by the U.S. Food and Drug Administration to study aspiration thrombectomy. The Alton Ochsner Medical Foundation in New Orleans is the only other medical facility participating in the South.

Physicians can apply the new procedure to remove blood clots from peripheral and coronary arteries, bypass grafts and veins. The therapy, which involves use of a new device called the AngioJet Rapid Thrombectomy System, is compatible with other cardiovascular treatments such as angioplasty, atherectomy and the use of stents.

“Aspiration thrombectomy clearly means life-giving potential for many people who previously could only hope for long-term drug therapy to dissolve their clots, and those therapies were often marked by debilitating side effects,” Lambert said.

Until now, physicians typically have used clot-busting drugs that can involve lengthy treatment — often in intensive care — and can cause uncontrolled bleeding. These risk factors have precluded patients with a history of strokes, bleeding disorders and kidney failure from undergoing the treatment.

Aspiration thrombectomy allows for the simple removal of clots from the coronary arteries, as well as clots that typically form during kidney dialysis and in other shunts, Lambert said.

The AngioJet system consists of a free-standing, reusable drive unit, a specially designed, flexible catheter and a sophisticated pump mechanism. Once inserted over a standard guidewire into the targeted blood vessel, the catheter delivers a pressurized saline solution from its tip, creating high-velocity jets that break up the blood clot and evacuate the resulting particles back through the catheter and out of the body.

The FDA selected the Health First Heart Institute as a site because of its nationally rated high-quality cardiac care, as well as Lambert’s earlier involvement in related studies at the University of South Alabama, where he directed the cardiac catheterization laboratories.

The study is expected to last about a year, with the heart institute reporting all data to the FDA for further study and evaluation. The procedure is covered by most insurance companies.