[net.med] new or experimental treatments

rokhsar@lasspvax.UUCP (Dan Rokhsar) (11/10/84)

Following a rather extensive knee reconstruction, a friend developed
a blood clot in his leg, part of which broke off and caused a 
pulmonary embolism, damaging a lung.  Unfortunately, the clot was
not detected for nearly two weeks; by that time it had grown,
so that it now stretches from ankle to nearly his hip, in the large
vein in the leg.  The doctors are treating him with anticoagulants,
but say that he will probably not be able to use his leg much, if 
at all, since blood flow is limited to the superficial veins now.

I would be very interested to hear about

a.	a hospital or medical school that is doing research
	in the treatment of vascular problems such as this

b.	a description of the changes that are undergone when
	the main vein to any part of the body is blocked for
	an extended period of time.  Is the damage reversible?

c.	why there don't seem to be any high tech treatments
	of blood clots (like using lasers, fiber optics,
	ultrasound, etc.) which can pulverize, destroy, remove,
	etc. the clot

d.	can veins be transplanted?

e.	any information on new procedures (which may be experimental
	in nature) which could help in this case

		Thanks in advance,

		Dan Rokhsar

norm@ariel.UUCP (N.ANDREWS) (11/14/84)

>Subject: new or experimental treatments
>Following a rather extensive knee reconstruction, a friend developed
>a blood clot in his leg, part of which broke off and caused a 
>pulmonary embolism, damaging a lung.  Unfortunately, the clot was
>not detected for nearly two weeks; by that time it had grown,
>so that it now stretches from ankle to nearly his hip, in the large
>vein in the leg.  The doctors are treating him with anticoagulants,
>but say that he will probably not be able to use his leg much, if 
>at all, since blood flow is limited to the superficial veins now.
>
>I would be very interested to hear about
>
>a.	a hospital or medical school that is doing research
>	in the treatment of vascular problems such as this
>
>b.	a description of the changes that are undergone when
>	the main vein to any part of the body is blocked for
>	an extended period of time.  Is the damage reversible?
>
>c.	why there don't seem to be any high tech treatments
>	of blood clots (like using lasers, fiber optics,
>	ultrasound, etc.) which can pulverize, destroy, remove,
>	etc. the clot
>
>d.	can veins be transplanted?
>
>e.	any information on new procedures (which may be experimental
>	in nature) which could help in this case
>
>		Thanks in advance,
>
>		Dan Rokhsar
>
>
extracted from nytimes 11/14/84:  ENZYME USED TO DISOLVE CLOTS IN CORONARIES
natural human enzyme made by genetiically altering bacteria effectively
disolves clots in the arteries of heart attack victims.
name: tissue plasminogen activator or t.p.a.
report presented monday nov 12 at annual mtg of amer. heart assoc
Dr. elliott B. Grossbard of Genentech, the south san francisco calif company
theat developed and tested the enzyme, said it had been tested on > 200 patient
at 25 hospitals in US and europe.  Superior to streptokinase and urokinase,
which temporarily suppress the body's ability to make new clots when they are
needed to stop bleeding.  t.p.a. appears to be more selective, breaking up old
clot without wrecking the coagulation machinery.
human testing began 9 mos ago at mass general hospital, johns hopkins medical
institutions, and the barnes hospital in st louis.
35/49ths of 49 heart patients had blood flow restored within, usually, 35 to 40
minutes of injection.  2 major studies now under way to compare t.p.a.
effectivesness with that of streptokinase.
t.p.a. acting on plasminogen -> enzyme plasmin which dissolves fibrin which
holds clots together.
dr. burton e. sobel, rschr at wash U. in st. louis has  experim with t.p.a. and
suggests that people of high risk of heart attack should carry t.p.a. around
with them to inject in themselves at first sign of heart attack.
hope this helps.   --norm andrews, vax135!ariel!norm  let me know if it does!