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Health Matters: Providence St. Mary Medical Center | 5 S teve Wilbanks had no idea how close to death he was as he drove himself to Providence St. Mary Medical Center last summer. His doctor had insisted the 49-year-old contractor get treatment right away. Wilbanks had been experiencing worrisome symptoms since the beginning of June, starting with severe leg pain that limited his ability to walk. He began having chest pain at the end of July. Soon he was coughing up blood. A few days before he arrived at Providence St. Mary in early August, he was sent home from another hospital after being quickly treated for what the medical staff there thought was a simple respiratory infection. Wilbanks's true diagnosis turned out to be much grimmer: acute pulmonary embolism, a massive blood clot obstructing both of his lungs. It had traveled from his leg all the way through the right side of his heart and into his lungs, where it suddenly became life- threatening due to a blockage of blood flow. ST. MARY'S OFFERS A GAME-CHANGING OPTION Fortunately, Providence St. Mary is equipped with FlowTriever, a first-of-its-kind thrombectomy system developed by Inari Medical to capture and remove large clots in a single mechanical session. And this is exactly what it did for Wilbanks—once he could be convinced to move forward with the procedure. "I don't like hospitals," he admits. Born and raised in San Bernardino, Wilbanks had been living in Idaho for the past three years, but he was in the High Desert for a contracting job when he fell ill. He'd been laboring through the pain and the difficulty breathing for weeks and was still hoping to return to his job the next day. "I wanted to just do blood thinners [as treatment]," Wilbanks explains. "Then they told me, 'No, you don't understand. If we don't get you into surgery, you're not going to make it till morning.' " Wilbanks was admitted to the hospital by cardiologist Mukeshchandra Patel, MD, a family friend of his employer. They immediately tested his heart rate and oxygen saturation, at which point "something alarmed them," he says. "Next thing you know, I'm getting blood drawn, put on a gurney, wheeled away for X-rays and a CT scan." REASSURING DOCTORS MAKE A DIFFERENCE As he signed the paperwork to authorize it, doctors were already preparing for Wilbanks's FlowTriever procedure, which would be led by Omar Saleh, MD, of the interventional radiology department. Despite the frightening nature of the situation—including that Wilbanks would be awake for the entire procedure—he says he wasn't as distressed as one might expect: "The surgeons made me feel comfortable the whole time, reassuring me that everything would be OK. They even asked me what type of music I liked and played some old rock 'n' roll for me." After being given an opioid, all Wilbanks could feel at first was the pressure of a tube going through his chest. Then he experienced a sharp pain and the feeling of blood rushing through his neck, face and head. Suddenly, he could fully breathe again. The makers of the FlowTriever describe it as an instrument featuring a highly trackable large-lumen catheter and large- bore syringe, designed to rapidly extract large volumes of clot while limiting blood loss. Dr. Saleh, who has been treating cases like Wilbanks's for almost a decade, says that, "compared to traditional methods of treating pulmonary embolisms, this Inari tool is a game changer." In the past, Dr. Saleh says, he would treat patients by giving them an IV of a clot-busting drug and hope it would break down the clot. "We'd send the patient to the ICU and sometimes that worked if the clot was fresh, but for this patient it was not fresh. It was an old clot," he explains. Today the outcome when using the FlowTriever is truly revolutionary. Dr. Saleh stresses, "When this device was not available, the patient could have either died or lived with a pretty big disability, like not being able to walk or do any daily activities." Indeed, it took only a few days for Wilbanks's cough to clear up. Then, a couple of days after the clot retrieval, he was brought back for follow-up surgery on his leg, where an inferior vena cava (IVC) filter was placed to catch any other potential blood clots. Wilbanks is a grateful patient who now understands the gravity of the situation he once faced. "If Dr. Patel hadn't ordered me to go to the hospital, I probably wouldn't have gone. He and the doctors who completed the procedure saved my life." In the Nick of Time A reluctant patient receives a lifesaving procedure at the last minute. To read more about the FlowTriever, visit providence.org/news/uf/653556502. Michael Neveux Photography

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