Hematologist treats astronaut’s thrombosis in longest-ever telemedicine consult

A hematologist-oncologist from the University of North Carolina has successfully treated a U.S. astronaut’s deep vein thrombosis (DVT) in the longest telemedicine consultation to date, Forbes reported Jan. 5.

The DVT was uncovered when the astronaut, who remains anonymous, underwent a routine neck ultrasound as part of a research study that was being performed on the International Space Station, Forbes reported. The study wasn’t designed to screen for blood clots, but when researchers confirmed a DVT in the astronaut’s internal jugular vein, NASA reached out to Stephan Moll, MD, back on the ground in North Carolina.

Moll opted to treat the large clot—a tough decision since the only blood thinner available on the ISS was a 40-day supply of enoxaparin, and the astronaut was just two months into a six-month stint on the space station. He called for the additional shipment of apixaban to the ISS, noting that since the risk of trauma to the astronaut’s body were high upon re-entry to Earth, they should stop taking the blood thinner four days before re-entry.

Forbes contributor Nine Shapiro reported that re-entry went smoothly, and the astronaut didn’t require any further therapy after leaving the ISS.

“But the events that occurred were unprecedented,” Shapiro wrote. “Little is known about DVT risk in space, nor is it known what put this particular astronaut at risk to develop a DVT in a large vein in the neck, as opposed to the leg. And given that this clot was without symptoms, had the ultrasound study not been taking place, it’s possible that this ‘silent’ clot could have dislodged, leading to a pulmonary embolism.”

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