The AI-enabled Penumbra Lightning technology has been the latest advancement in treating pulmonary embolisms — clots in the lungs that stop blood flow to the lung arteries. The Penumbra Lightning 12 F Catheter selectively removes blood clots, thereby reducing blood loss and complications like anemia while increasing the speed of recovery. Medanta, a hospital in Gurugram, has used this technology in the successful treatment of 25 cases of pulmonary embolism since July 2023. “The traditional catheters would suck out blood along with the clots. As a result, the person would lose a lot of blood,” informs Dr Rajiv Parakh, Chairman, Peripheral Vascular and Endovascular Sciences, Medanta, Gurugram.
Prolonged hours of sitting pose a risk
A 62-year-old man experiencing sudden leg pain and swelling was brought to the emergency room at Medanta, Gurugram. He was diagnosed with deep vein thrombosis (DVT) in his left leg and a non-obstructive clot on his left lung lobe.
“Prolonged hours of sitting at work or during long flights can cause the blood circulation in the legs to slow down, causing clots in the legs, known as deep vein thrombosis (DVT). These clots can move from the legs to the lungs, causing breathing difficulties and pulmonary embolism,” says Dr Parakh. One can develop leg clots during long flights. When the person begins to walk, the clot can move up to the lungs.
The man’s clots were removed using the AI-enabled catheter. He was discharged in two days, doctors recalled.
Advanced AI technology: How does it work
“The traditional treatment for pulmonary embolism consists of blood thinners and clot-busting medicines. However, large clots are sucked out with the Penumbra device,” says Dr Virbhan Balai, consultant interventional cardiologist, Manipal Hospitals, Dwarka, Delhi. He opines that the Penumbra procedure is challenging and is done selectively.
Conventional catheters would suck blood along with the clots, as they couldn’t gauge when to stop. This would cause the person to lose a lot of blood. The AI-enabled device attached to the suction machine only sucks the clots. When it comes in contact with the flowing blood, it stops the suction, and the blood loss is minimal. Dr Parakh shares, “Previously, only an incomplete clot removal was possible, because of the massive blood loss. Now a total clearance of the clot is possible.”
According to Dr Balai, while the Penumbra device has been in use, the AI-enabled Penumbra device is an advancement.
Treatment options for pulmonary embolism
Dr Udaya Sureshkumar, associate consultant pulmonologist, KMC Hospital, Manipal Group Hospitals, Mangaluru, Karnataka, shares that the treatment for pulmonary embolism depends on the severity of the person’s symptoms.
“In case of acute symptoms involving sudden onset of breathlessness and a drop in blood pressure, it is considered an emergency,” says Dr Udaya. After confirming the diagnosis of pulmonary embolism through a CT scan, thrombolysis (administering medicines to dissolve the clot) is performed. However, it can have complications like bleeding.
Dr Udaya shares, “In less severe cases, where the person’s blood pressure and heart rate are stable and the hypoxia is not severe, anticoagulants (medicines that help prevent blood clots) are given subcutaneously, via injections.”
She adds that anticoagulants are also used to treat deep vein thrombosis. Filters are also employed in the veins to prevent the leg clot from getting dislodged and ending up in bigger systems like the lungs while anticoagulation is underway.
Dr Udaya says that the new AI-driven technology can be a step in the right direction. This is because medications are not always enough — there are chances that the clot can recur. Besides, thrombolysis injections can be costly and pose risks. “Surgical interventions may significantly reduce such risks,” says Dr Udaya.
Further research needed
Dr Balai says that more research needs to be done to find out if the new AI technology has an edge over the conventional methods. “As this technology has still not been used widely in clinical settings, we do not have sufficient data to support or refute the beliefs,” says Dr Balai. “The existing findings are observation-based — only after the AI method is used in clinical settings extensively will we be able to gather more robust data.”
Dr Balai concludes that if the AI-enabled Penumbra Lightning technology is found to have an edge, it can be incorporated into regular angioplasties too.
Takeaways
The AI-enabled Penumbra technology is the latest advancement in treating pulmonary embolism. It is considered to selectively remove blood clots, reduce complications and improve recovery time. More research is required to understand the benefits of this treatment over conventional methods.
