Doctors: stroke patients waiting for new stent treatment

Blood clots caused by rare condition often seen in younger women

Dr. Jeff Apple treated Heatherly McDaniel for a life-threatening blood clot. (KXAN Photo)
Dr. Jeff Apple treated Heatherly McDaniel for a life-threatening blood clot. (KXAN Photo)

AUSTIN (KXAN) — No warning and a stroke can strike. It happened to one Austin woman, whose only treatment is a stent that is not on the market yet.

Heatherly McDaniel, 41, knew something was off the day she had a stroke in April last year. Her then 16-year-old daughter recognized the slurred speech and numbness on one side.

“She looked at the situation and she said, ‘This is out of character for our mother,'” McDaniel said. “The only thing she could think of is it has to be a stroke.”

Her family rushed her to the hospital, where emergency room doctors treated the stroke, caused by a blood clot. But less than two weeks later, her left leg suddenly started to swell. It was another massive clot nowhere near her heart or brain. McDaniel was young, healthy and had no recent surgeries, not the mold of a person prone to blood clots.

“The problem that Heatherly had was right here,” said Dr. Jeff Apple, pointing to a large scan of McDaniel’s pelvic area. Apple is a vascular surgeon with Cardiothoracic and Vascular Surgeons in Austin. His scans discovered a massive blood clot near McDaniel’s legs, not the typical place clots usually form.

A rare condition, called the May-Thurner syndrome, caused one of the major veins in her left leg, the Iliac vein, to be cut off, blocking McDaniel’s blood flow.

“Her vein is like having one lane closed on Interstate 35,” Apple said, referring to one of Austin’s major, mostly congested highways. “When we put a stent in, we open it up to two lanes, traffic should move as fast and as normal as it should.”

The new stent Dr. Apple used isn’t available yet. McDaniel was part of a clinical trial. Dr. Apple said most surgeons are still using stents created 20 years ago, and they are not designed for larger leg veins.

And the types of clots caused by the May-Thurner strike young women, including her sister McDaniel’s younger sister.

“The typical phone call we get is an 18, 22-year female who has recently started on birth control pills about six weeks ago and they get a huge left sided blood clot.” Apple said.

So far, McDaniel said she has only had small side effects.

“My leg tingles, my toes tingle and most of the times I can deal with it, ’cause that’s pretty minor compared to a few people I’ve met who have had strokes,” she said.

Doctors say the next step now is to monitor patients for the next year to determine if the stent is safe for other patients. If McDaniel had not qualified for the trial, doctors would have treated her condition with life-long blood thinners and compression sleeves.

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