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Inventing a New Way to Dissolve Dangerous Blood Clots

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A Q&A with Dr. Riyaz Bashir

Posted by Temple Heart & Vascular Institute

Temple cardiologist Dr. Riyaz Bashir has spent decades treating patients with various types of blood clots. This experience, combined with his vast insight into the body’s clotting behavior, led him to design a groundbreaking device to break up hard-to-treat blood clots that form in the veins and lodge in the lungs.

FDA-approved for deep vein thrombosis (DVT), the device — called the Bashir™ Endovascular Catheters — has already helped hundreds of patients make a full recovery from dangerous, life-threatening clots. The Bashir Endovascular Catheters are currently in clinical trials for the treatment of acute pulmonary embolism (PE), which occurs when a deep vein clot breaks away and travels to the lungs.

Q: Why was the Bashir Endovascular Catheter needed?

Dr. Bashir: Acute venous thromboembolic (VTE) disease is marked by blood clots that start in a vein — often in the deep veins of the leg, groin or arm — but then break off and travel to the lungs where they cause a pulmonary embolism. This is a condition that kills up to 100,000 Americans each year. The ability to clear these clots and restore blood flow can be the difference between life and death for some of these patients.

Q: How did you come up with the idea for the catheter?

Dr. Bashir: I’ve always been dissatisfied with the treatment options for large, particularly dangerous blood clots. These large clots are hard to dissolve with medication and tricky to remove surgically. I designed the Bashir Endovascular Catheters to produce better outcomes by rapidly restoring blood flow through the clot, thereby enhancing its breakdown and dissolution.

Q: How does the device work?

Dr. Bashir: The catheter is advanced through a patient’s vein or artery, to the location of the blood clot, where it expands, restoring blood flow through the affected blood vessel. Once there, it delivers a small amount of clot-dissolving medicine directly into the clot. In addition, expanding the mini catheters within the clot also allows patients own blood to flow through the clot. This is key because a patient’s blood has a lot of clot-dissolving enzymes in it. When these enzymes are combined with small amounts of clot-dissolving drugs, they create a dramatic synergistic effect to rapidly dissolve the clot.

Q: What is unique about the device?

Dr. Bashir: There are several things that set the Bashir Endovascular Catheters apart. Other catheters are designed for small arteries, but blood clots that cause life-threatening DVT and PE are lodged in very large vessels. The diameter of these vessels are 25 to 30 millimeters, and we were using devices that were made for 5 millimeters vessels. No wonder they weren’t doing a good job!

The Bashir Endovascular Catheters' ability to expand in size and break through these large clots allows a much larger surface area of the clot to get exposed to the clot-dissolving medicine.

The Bashir Endovascular Catheters are also unique because it’s the only catheter of its kind that, once advanced into the clot, can be expanded by the physician into 6 ‘mini-catheters’ to deliver medications in precise locations throughout the cross section of the clot.

Q: What has been the impact of the Bashir Endovascular Catheters and what are the next steps?

Dr. Bashir: The device has been approved to treat deep vein thrombosis and is now being used by physicians across the country to treat this very serious condition. It will save countless lives throughout the globe. The device is also now in clinical trials for the treatment of acute pulmonary embolism, which is the third deadliest cardiovascular condition.

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