Prachi Rathi, a 22-year-old IT professional, came to Mumbai’s Wockhardt hospital with complaints of painful swelling of left leg for three days.

On evaluation she was diagnosed with haemoglobin - 6.4gm% (anaemia) and clogged veins of left leg due to multiple clots (deep vein thrombosis).

The next afternoon, she developed breathlessness with very low oxygen saturation - 67%. On further evaluation with pulmonary CT scan, she was found to have clogged arteries of pulmonary circulation (massive pulmonary thromboembolism).

Dr Ashish Mishra, Wockhardt Hospitals, said, “On evaluation in the emergency department, the patient was breathless with discomfort and oxygen saturation of 65%.”

“The patient was emergently rushed to Cath lab suite for intervention”. The patient underwent successful complex pulmonary embolism intervention (a minimally invasive procedure) under local anesthesia which included removal of clots from large sized branches of pulmonary arteries via advanced catheter based system (Mechanical Thrombectomy) followed by administration of clot lytic medication – Alteplase (Catheter Directed Thrombolysis),” he added

After six hours of completion of potent clot lytic medication, repeat CT scan was done which showed successful clearance of clots from pulmonary arterial circulation. Next day the patient underwent successful implantation of IVC filter (a medical device specially designed to prevent blood clots from reaching the lungs) with a minimally invasive procedure.

Dr. Mishra added, “The patient was simultaneously worked up for the underlying cause and was diagnosed to have a rare thrombotic disorder called anti-phospholipid syndrome (APS).”

APLA syndrome, also known as antiphospholipid syndrome, is an acquired autoimmune disorder characterized by the presence of abnormal antibodies in circulation which mistakenly attack proteins involved in blood clotting pathways. As a result, individuals with APLA syndrome experience abnormal blood clotting and consequences.

The breathlessness recovered and the patient was free from supplemental oxygen after 48 hours of intervention. The patient was discharged in clinically improved condition with oral blood thinners and supportive therapy.

“Emergent sequential cath-intervention via minimally invasive approach helped to save the life of a patient,”  Dr Mishra added.