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Minimally Invasive Catheter Directed Thrombolysis: Norman’s Story


Thursday, September 18th, 2014

Norman Melser is an avid runner. The 68-year-old retired landscaper and pastor had an average weekly running distance of around 40 miles and participated in various races each year, including the Pittsburgh marathon.

But his ability to run was almost destroyed when he was diagnosed with a limb-threatening condition.

On April 17, 2013, Norman felt a sudden, severe pain in his right leg. The pain quickly turned to numbness and weakness, and he sought medical attention at his local hospital. He was transferred to UPMC Presbyterian, but by the time he arrived at the hospital, his right foot was cold with loss of sensory function and increasing weakness.

A CT scan revealed an artery “ballooning” behind his knee, full of clot. Part of this clot migrated down to all three small arteries of his right leg – allowing no blood flow to the foot.

Norman had a condition called ischemia, which is restriction of blood flow to the heart caused by a partial or complete blockage of the heart’s arteries. Ischemia can lead to amputation or residual walking disability, depending on the extent of the condition, timing of management, and outcome of overall treatment. Conventional surgical techniques require complex, open clot removal through the small leg arteries and bypass – many times with less than satisfactory results.

Instead, Norman’s vascular surgeons at UPMC, Drs. Rabih Chaer and Efthymios Avgerinos, decided to treat him with a minimally invasive procedure called catheter directed thrombolysis. This procedure is the infusion of clot busters through a catheter that’s placed within the clotted arteries through a single puncture of the groin. After 36 hours of surgery, Norman’s clot was removed and his blood was circulating properly

Now he’s back to the sport he loves. “Doctors Chaer and Avgerinos are very special,” says Norman. “I was extremely appreciative of their encouragement to continue running. Dr. Avgerinos even said before discharge, ‘Now run for the hills! It’s good for circulation!'”

Norman was discharged within five days of surgery and returned to running a month later. This year, he completed the Pittsburgh half marathon with the amazing time of 1 hour and 57 minutes.

Norman’s story has a happy ending and he is back enjoying the same activities he did before his diagnosis. If you would like to hear more stories like Norman’s, learn more about developments in the field of vascular medicine, or have a question about a problem you may be experiencing yourself, please visit the UPMC Heart and Vascular Institute online or call 1-855-UPMC-HVI (876-2484) to schedule an appointment.

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Heart and Vascular Institute

As a recognized leader in cardiovascular care — with a rich history in clinical research and innovation — the UPMC Heart and Vascular Institute offers a full spectrum of personalized cardiovascular services. As one of the first heart transplant centers in the United States, UPMC has made significant contributions to the advancement of cardiovascular medicine. Read More