My name is Mark Garcia. I’m an interventional radiologist who practices in the state of Delaware at Christiana Care, a large tertiary care facility. It also has an academic practice. I’ve been in the field of radiology practice now for about 17 years.
How did you decide to become a doctor?
Actually it was sort of an easy thing. I became a doctor because it’s what I grew up with. My father was a physician. He was a surgeon and I figured I would do surgery but while at med school I did a rotation in interventional radiology—my first one at Thomas Jefferson Medical College in Philadelphia. It was the first time they offered the rotation and I came out of there saying I wanted to switch my desire. I found it fascinating, and I’m very happy that I did.
What are you presenting on this weekend?
I presented on chronic venous disease and our ability to change how people suffer from post thrombotic syndrome. I discussed some of the tips and tricks that we use in order to be able to recanalize or open up the chronically occluded veins that have caused patients to have post thrombotic syndrome, which is really a continuum of symptoms from pain in leg swelling all the way to venous ulcers and gangrene. We’ve, over the last several years, been very successful in being able to change these patients qualities of life—the quality of life of those suffering from it—and make their symptoms significantly improved if not completely go away.
How does this treatment differ from previous treatments?
Well, the previous treatment was always anticoagulation and compression stockings, and for many people that just doesn’t work. It may help their symptoms get some relief, but the patients we see typically have been suffering for awhile and it just has failed. So they’re looking for something to get their quality of life better—to be able to play with their grandkids or their children or just be able to walk around and do things that they haven’t been able to do for some time. And so we’ve shown, through our work, that it can be successful and that the consideration that there’s no option is no longer there. We’re trying to change that idea within the medical community. To allow patients to get better. Have a better life.
How do you think things will change in the next five to ten years?
My hope is that we can, as we move forward with the need for evidence based medicine, we are hoping that a good randomized study of this will look at how all physicians look at people who have been given the drugs and the stockings and told here you go, there’s nothing more that can be done. If that’s the case, I think that we’ll be able to show that you can literally change the face of post thrombotic syndrome in these patients and really change the way physicians handle their patients who have this disease.
Do you have any specific patient stories that you’d like to share?
Oh, we’ve got dozens and dozens. One of the great ones is a woman who, at the time, was 65, who had a hysterectomy, and during the surgical procedure they injured the iliac vein. They called a vascular surgeon in to try to repair the vein but they could not, so they ligated the vein. And she woke up with a very painful, swollen leg from anesthesia and it consequently clotted off her whole leg, all of the veins in her legs. She lived like that for twelve years. For twelve years, she had essentially no quality of life. As she explained to me, she couldn’t play with grandchildren, she couldn’t cook, she couldn’t stand by the stove for five minutes without having significant pain. Ultimately, after twelve years, a surgeon who saw her told her, “You really ought to go to Dr. Garcia. He’s doing some work here. Maybe he can help you.” So we undertook the procedure the way we do it, and we were very successful in getting through the clot, opening everything up, restoring complete flow in her leg. I saw her in September for her two-year follow up. She has no symptoms. She exercises, treadmill, every day. She travels now and just lives a much better lifestyle, and she’s extremely happy with her outcome.
What advice do you have for patients?
I think that the most important thing to know is that there is help out there. It may be very difficult to find that help, but there are people who are willing and able to treat them. It is not the standard of care, and they have to understand that, but that’s part of our job—to make it the standard of care. And we’re going to need help with doing that, from both industry and physicians and insurance companies. But I think ultimately the message really needs to be, you have potential help that can be given to change the course that you’ve unfortunately had with this disease.
Is there anything else you’d like to share on it?
No. Keep your chin up and hopefully there will be saving techniques coming your way, close by, and if not seek out that help and hopefully you’ll have a good outcome.