Alan's remarkable recovery: triumph over a Pulmonary Embolism with innovative care

11 October 2023

Most of us have experienced the sudden panic of not being able to breathe. Whether from choking on food or being unexpectedly pulled underwater, those few seconds can feel like an eternity. Imagine how terrifying that feeling would be if you didn't know the cause – what was stopping you breathing – or what you needed to do to put it rightThat is exactly what happened to 74-year-old Alan from South Africa.    

Alan was going about his normal day, working outside in the fields, when suddenly he was struggling, gasping for air. "I couldn't breathe," he says, remembering how scared he wasHe managed to get back to the house to his wife, Maureen, who, after speaking to their family doctor, rushed him to the Emergency Department of a local hospital, Hillcrest. Although she didn’t know it at the time, that decision Maureen made of which hospital to take Alan to turned out to be one that saved his life. 

Alan’s body was being starved of oxygen and his condition was deteriorating 

Dr Graham Laurence, Specialist Physician in the Emergency Department at Hillcrest, was the first doctor to see Alan and says initial tests showed he was hypoxic, meaning his inability to breathe properly was depriving his body tissue, vital organs and brain of oxygen. Alan’s condition was deteriorating rapidly, and he felt like he was going to pass out. Desperately trying to get air into his lungs, he feared the worse when he overheard one of the medical team saying he was "very, very far gone".   

A specialist scan -  a CT pulmonary angiogram - revealed the cause of the problem: Alan had a large blood clot lodged in his lungs (a pulmonary embolism, or PE) with lots of smaller clots (thrombus) in both the left and right pulmonary arteries, large blood vessels that fulfil a vital role in getting blood from the heart into the lungs to be oxygenated.     

"I didn't even know what an embolism was at that stage," Alan says "All I can remember was trying to breathe.  I just could not get air into my system." 

Alan was lucky to be in the best possible place to get the right treatment 

Alan’s condition was critical, but he was incredibly fortunate that Hillcrest Hospital boasts an excellent vascular facility that had just acquired a specialist device for treating PE that had only recently been made available in South Africa – the EKOS™ Endovascular Systemfrom Boston Scientific.  Dr Mariusz Tarkowsi, Vascular Surgeon, understood the life-saving potential of the EKOS™ device and recognised how important it was to ensure all the relevant departments knew about this new technology and the impact it could have. He had worked with the different teams involved in the diagnosis and care of PE to make them aware of the EKOS™ device and to put in place a rapid response protocol and referral pathway that could be deployed in urgent cases such as Alan’s. After seeing Alan’s haemodynamic test results, Dr David Skinner from the Critical Care Team triggered this emergency protocol, and the multidisciplinary team sprang into action to prepare him for the EKOS™ procedure.  “I had all these wonderful doctors running around,” says Alan, eternally grateful for the urgent attention he received. 

Even the doctors were amazed by Alan’s response to the EKOS procedure 

The EKOS™ procedure itself lasted just 45 minutes. When Alan came out of theatre, he was, he says, “absolutely amazed” that he could breathe freely again.   

Meanwhile, back at home, Maureen was anxiously waiting for news. She recalls that when the call from the hospital came, she was told that even the doctors, who had relatively little experience of the new EKOS™ device, "were amazed he was actually breathing on his own. They never expected anything like that."   

Alan says he’s keen for people to understand what happened to him and the fantastic treatment he received at the hospital from the various medical specialties who came together to save his life, "What they did was outstanding. Those doctors were almost miracle workers as far as I'm concerned.” 

He also wants to stress how grateful he is that the hospital he went to had the EKOS™ device and a rapid-response protocol in place use it in emergencies such as his. "Today, I lead an absolutely normal life. I'm 74 and can still do anything I like. I'm very fit at the moment and I give thanks to that machine. I know it saved my life and if it was not in the hospital when I went there, I would have been dead today." 

Maureen reinforces the life-saving difference that the EKOS™ device made: "I was told by the doctors that if I hadn't taken him to that particular hospital where that particular machine was, I would have been arranging a funeral."     

About Pulmonary Embolism (PE) 

A PE usually originates as a clot (or thrombus) that forms in the leg as a deep-vein thrombosis (DVT) before being carried to the lungs in the bloodstream, where it gets trapped. If not recognized and treated promptly, a PE can lead to long-term damage to the function of the heart, heart attack and even death. PEs are most common in people over 60 years of age, but other risk factors include pregnancy and childbirth, a sedentary lifestyle and being overweight.     

About the EKOS™ Endovascular System  

The EKOS™ Endovascular System is used for ultrasound-assisted, catheter-directed thrombolysis to quickly and safely dissolve pulmonary embolism (PE). Minimally invasive, EKOS™ leverages the power of targeted ultrasonic waves to thin and separate fibrin strands and accelerates lytic dispersion deeper into the clot. 

EKOS™ was the first interventional device indicated for the treatment of pulmonary embolism. It is also used to treat deep vein thrombosis (DVT) and peripheral arterial occlusion (PAO).  
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