Blood Clot Threatened First Responder’s Health

Grant Capel has spent most of his life in excellent health. But in late 2011, he was diagnosed with bladder cancer.

“I had never taken a sick day in my life until I was diagnosed with cancer,” says Capel, who works as a paramedic and firefighter in rural Union County, Illinois. “I wasn’t used to being sick or being in a hospital. I was used to helping other people. But in this case I was on the receiving end.”

Arnold Bullock, MD, a Washington University urological surgeon at Barnes-Jewish Hospital, removed Capel’s bladder and formed a neobladder–which functions in place of the bladder–inside his body. The operation was a success, and Capel’s recovery was smooth.

A few years later–in May 2015–Capel underwent a routine CT scan to ensure that his cancer hadn’t recurred. When Dr. Bullock called him at home the same evening, Capel knew the news couldn’t be good.

Though the cancer had not returned, radiologists had discovered an unusually long thrombus, or blood clot, in the inferior vena cava, the main large vein that carries blood from the lower body to the heart. They informed Dr. Bullock, who consulted with ER physicians and vascular surgeons before calling Capel.

AngioVac Procedure Patient, Grant Capel

AngioVac Procedure Patient, Grant Capel

“Dr. Bullock said, ‘I don’t want to alarm you, but this is very, very large,’” Capel says. “He told me to return to the hospital in the morning.”

So Capel, who is married and has two children, packed his bags that night and was admitted the next day to Barnes-Jewish Hospital, where he learned that the blood clot in his abdomen was more than 8 inches long, extending from his pelvic area up to his kidneys. He met with Mohamed Zayed, MD, PhD, a Washington University vascular surgeon at Barnes-Jewish Hospital, who explained the options: open surgery, clot-busting medication or a new procedure called AngioVac.

“In an open surgery, we create an incision in the abdomen under general anesthesia and manually remove the thrombus; it’s a fairly complicated procedure,” Dr. Zayed says. “Thrombolysis, or clot-busting medication, was an option for Grant, but because his thrombus was large and appeared to be somewhat free-floating, we were concerned that part of it could break off and migrate to his heart or lungs, which could be life-threatening.”

Capel and Dr. Zayed agreed that the AngioVac procedure was the best treatment option. During this procedure, surgeons use X-ray image guidance to insert a suction catheter into a tiny incision or puncture in the base of the neck or groin. They then thread the catheter through the vein, and a funnel at the tip of the catheter suctions out the blood clot in one piece. The blood is then filtered and pumped back into the body through an inflow catheter inserted into a separate puncture site.

“Dr. Zayed presented me with my options and explained how dangerous my situation was without scaring me,” Capel says. “Having dealt with heart patients for three decades for my job, I had a good grasp of what was going on. Even though AngioVac was new, I decided it was the most prudent choice. I knew that at Barnes-Jewish, I was in the right place with the right people.”

The following Monday, Capel underwent the procedure, the seventh person to do so at the Washington University and Barnes-Jewish Heart & Vascular Center. Dr. Zayed and his team removed the entire blood clot with no issues.

By the end of the week, Capel was home. A few weeks later, he was back at work and feeling great. Today he has no medical problems related to the procedure.

“It is incredibly rewarding to have Grant be able to return to his work as a firefighter and paramedic,” Dr. Zayed says. “We were able to help him do that, and he continues to be active without any problems.”

In addition to his job as the director of Union County Ambulance Service, Capel serves as school-board president and is active in his church and community. He credits his doctors and the staff members at Barnes-Jewish Hospital with his ability to return to an active life.

“Had it not been for the sharp eye of the radiologists who saw the thrombus, the efforts of Dr. Bullock and the efforts of Dr. Zayed and his team, who performed the AngioVac procedure, I might not be here today,” Capel says. “There are very talented people at Barnes-Jewish. They are the reason I can still do my job and help people.”

He says he often explains the AngioVac procedure to others, wanting to help them understand that it is a valuable treatment option for people with large blood clots in abdominal or pelvic veins.

“My job now is to try to help somebody else–to pay it forward,” Capel says. “I’m grateful to be here and happy to do it.”

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Category: Heart & Vascular

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Barnes-Jewish Hospital at Washington University Medical Center is the largest hospital in Missouri and the largest private employer in the St. Louis region. An affiliated teaching hospital of Washington University School of Medicine, Barnes-Jewish Hospital has a 1,800 member medical staff with many who are recognized as "Best Doctors in America." They are supported by residents, interns and fellows, in addition to nurses, technicians and other health-care professionals.

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