Device Can Help COVID-19 Patients Who Develop Dangerous Clots

The heart team at Virtua Our Lady of Lourdes Hospital is using a new tool to treat pulmonary embolism, a life-threatening clot in the lungs. A device called the FlowTriever® uses a catheter to remove a clot from the lung arteries and the body, immediately restoring blood flow and a patient’s ability to breathe.

“Just as when we open a clogged artery in a person having a heart attack, using FlowTriever in a patient’s lung restores blood flow and results in rapid improvement,” said Ibrahim Moussa, DO, FACC, FSCAI, RPVI, an interventional cardiologist at Virtua Our Lady of Lourdes Hospital. “Performing this procedure through a catheter, we avoid open-chest surgery and long intensive care unit stays, as well as drugs that can increase bleeding risk.”

Virtua Our Lady of Lourdes has the most experience using the FlowTriever of any hospital in South Jersey. Recently, the Virtua team used the device to successfully remove a pulmonary embolism in a patient hospitalized with COVID-19. Doctors have found that people with the coronavirus have an increased risk of developing blood clots. It is not clear why this occurs.

First-of-its-Kind Technology

The FlowTriever, manufactured by Inari Medical, is the first FDA-approved mechanical thrombectomy device purposely designed to treat pulmonary embolism. 

With the FlowTriever, a catheter is inserted through a vein in the groin area and threaded to the pulmonary arteries of the lungs. Suction is used to pull the clot out of the vessel and the body.

If the clot is adherent to the wall of the vessel, a tool on the tip of the catheter will bury into the clot and three self-expanding mesh discs will work to drag it out.

“This device offers us many advantages. We are able to remove large clots from large vessels, immediately restoring blood flow. We don’t have to use clot-busting thrombolytics, and since this is a minimally invasive, catheter-based procedure, we can better treat patients who are not candidates for open-chest surgery,” said Dr. Moussa.

A Promising Alternative

Commonly, initial treatments for pulmonary embolism are blood thinners, like heparin and warfarin. Blood thinners will keep the clot from getting bigger and work well for smaller clots, but may or may not completely dissolve bigger clots.

Doctors also may use thrombolytics, or clot busters, in conjunction with ultrasound waves delivered through a catheter to break up a clot. However, thrombolytics, like blood thinners, increase the possibility of internal bleeding and may pose an unsafe risk to older patients, according to Dr. Moussa.

If the clot cannot be removed or treated with these methods, surgeons may perform open-chest surgery to remove it. This involves making a large incision down the center of the chest and through the breastbone to access the heart and lungs. A heart-lung machine is necessary for this type of procedure to take over the heart pumping and the lungs breathing.

“While sometimes necessary, open-chest surgery is traumatic and can require months to recover,” said Dr. Moussa. “FlowTriever will serve as a promising alternative and we are pleased to provide this tool for our patients.”