First Pulmonary Embolism Patients in Hong Kong Treated with the EKOS System

BTG plc, a global specialist healthcare company, announced the first patients diagnosed with pulmonary embolism (PE) to be treated in Hong Kong, China, using the newly available EKOS system.

The EKOS system includes an ultrasonic device that uses acoustic pulses to quickly and safely dissolve blood clots and restore blood flow in patients with PE, deep vein thrombosis (DVT), and peripheral arterial occlusions (PAO).
 
Blood clots are tightly bound together in a fibrous mesh called fibrin. Fibrin blocks the flow of thrombolytic drugs, requiring a higher drug dose to be effective. The EKOS system uses acoustic pulses to unwind and thin fibrin to expose drug receptor sites, allowing the drug to reach deeper into the clot, accelerating absorption and helping to dissolve the clot faster and with less thrombolytic.^1,2
 
Dr. Luk Wing Hang, Consultant Radiologist at the Princess Margaret Hospital, who performed the procedure on one of the patients, said, “Prevalence of fatal PE was 0.21 percent (1964-74), 1.08 percent (1975-79), 1.83 percent (1980-84), 2.77 percent (1985-90), and 4.7 percent (1990- 94) and the trend has been found to be increasing year after year with the percentage approaching western countries’ occurrence rate.” In addition, Luk said the patient treated with the EKOS system was clinically stabilized with no desaturation or shortness of breath and their blood pressure was back to normal.
 
Later, in the same week, another case of submassive pulmonary embolism was treated just eight miles away at the Prince of Wales Hospital, where interventional cardiologist Prof. Bryan P. Yan was the treating physician. “The EKOS system enables much lower and safer doses of thrombolytic drugs to be used which significantly reduces the risk of major bleeding. The device is currently the only U.S. FDA-cleared, minimally invasive endovascular therapy for PE,” he said. “Our patient’s condition was improved significantly after 12 hours of ultrasound assisted thrombolysis with the EKOS system. His breathing and blood pressure were improved and his grossly dilated right heart returned to nearly normal size and he was successfully discharged home.”

The EKOS system is now commercially available to hospitals in Hong Kong. The EKOS system is distributed in Hong Kong by PPL Medical Limited which has distributed life-saving medical devices and equipment in Hong Kong and Macau for more than 35 years.
 
“I am pleased to introduce our ultrasonic catheter device to the Hong Kong market to improve the treatment of severe blood clots. BTG is committed to delivering a better standard of care for patients who suffer from PE, DVT and PAO, with improved outcomes and lower associated risks through the development of minimally invasive therapies like the EKOS system,” said James Glasgow, general manager at BTG Asia.
 
Pulmonary Embolism is a condition where one or more clots break off or travel from existing venous clots in the legs or arms and travel in the circulation, getting trapped in the lung, where they block the ability of blood to get to some areas of the lungs and receive oxygen. This may lead to a strain on the heart’s ability to pump blood through the lungs which can then lead to heart failure and/or cardiovascular collapse. PEs can be immediately fatal, but if PE can be diagnosed and appropriate therapy started, the mortality can be reduced from approximately 30 percent to less than 10 percent.⁷
 
The EKOS system uses ultrasonic waves in combination with clot-dissolving thrombolytic drugs to effectively dissolve clots and restore healthy heart function and blood flow. In clinical studies EKOS therapy has been shown to speed time-to-clot dissolution, increase clot removal and enhance clinical improvement compared to either standard catheter-directed drug therapy or thrombectomy.^4,5 EKOS therapy requires significantly shorter treatment times and less thrombolytic compared to standard catheter-directed drug therapy,⁶ lowering the risk of bleeding and other complications.^2,3
 
BTG is a global specialist healthcare company bringing to market innovative products in specialist areas of medicine to better serve doctors and their patients. It has a portfolio of interventional medicine products to advance the treatment of cancer, severe emphysema, severe blood clots and varicose veins, and specialty pharmaceuticals that help patients overexposed to certain medications or toxins.
 
References:
1. Chau KY, Yuen ST, Ng TH, Ng WF. An autopsy study of pulmonary thromboembolism in Hong Kong Chinese. Pathology 1991;23:181-4. Chau KY, Yuen ST, Wong MP. Clinicopathological pattern of pulmonary thromboembolism in Chinese autopsy patients: comparison with Caucasian series. Pathology 1997;29:263-6.
2. Kucher, N., et al., “Randomized, Controlled Trial of Ultrasound-Assisted Catheter-Directed Thrombolysis for Acute Intermediate-Risk Pulmonary Embolism.” Circulation, Vol. 129, No. 4, 2014, 479–486.
3. Piazza G et al. A Prospective, Single-Arm, Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism. The SEATTLE II Study. J Amer Coll Cardiol: Cardiovasc Interventions 2015; 8(10):1382-1392.
4. Lin, P., et al., “Comparison of Percutaneous Ultrasound-Accelerated Thrombolysis versus Catheter-Directed Thrombolysis in Patients with Acute Massive Pulmonary Embolism.” Vascular, Vol. 17, Suppl. 3, 2009, S137–S147.
5. Lin, P., et al., “Catheter-Directed Thrombectomy and Thrombolysis for Symptomatic Lower-Extremity Deep Vein Thrombosis: Review of Current Interventional Treatment Strategies.” Perspectives in Vascular Surgery and Endovascular Therapy, 2010, 22(3): 152–163.
6. Parikh, S., et al., “Ultrasound-Accelerated Thrombolysis for the Treatment of Deep Vein Thrombosis: Initial Clinical Experience.” Journal of Vascular and Interventional Radiology, Vol. 19, Issue 4, April 2008, 521–528.
7. Banovac, R et al., J Vasc Interv Radiol, 2010; 21:44-53.