Thursday, April 24, 2008
Alaska Olympic Skier Kikkan Randall Diagnosed With May-Thurner Syndrome As A Cause Of Her Recurring Blood Clots
A trip to Providence Alaska Medical Center to treat a new blood clot turned into a lengthy ordeal last week for Olympic cross-country skier Kikkan Randall (pictured at left), who emerged from the hospital six days later with a new diagnosis. Full story published April 24th, 2008 in the Anchorage Daily News and the SkiRacing.com website. Related earlier ADN story HERE. Wikipedia entry HERE.
Randall's doctors now believe her repeat episodes of deep vein thrombosis, or DVT, are partly a result of May-Thurner Syndrome -- a condition where the left iliac vein is squeezed so tightly by the right iliac artery that the pressure impedes the blood flow in the left leg. The syndrome often occurs among fit, young women, and is partly attributable to the curve of the female spine exerting pressure on the vein in tandem with a well-muscled back, said Dr. Chakri Inampudi, the interventional radiologist who treated Randall. At the same time, the artery pushes from the front, and the vein gets squeezed in between these two structures, according to Dr. Inmapudi.
Randall will undergo ultrasound tests in upcoming weeks to determine whether the veins in her left leg remain clot-free since her most recent treatment. The problem is that the clots are not something that can be seen right away, and that the symptoms are slow to develop.
If the blockage does return, doctors may insert a stent, or reroute the vein through bypass surgery.
The first time the problem surfaced, Dr. Erik Maurer, who is Dr. Inampudi's colleague, snaked a clot-busting angiojet into the iliac vein of her left leg and dissolved most of her first DVT, then located primarily in her pelvis. But this time, there was a more extensive series of clots in two veins - extending from her left calf to her left hip - proved more stubborn. Randall remained bed-bound at Providence throughout the week as Inampudi used an ultrasound-assisted catheter to disperse a clot-busting drug in both her iliac and iliofemoral veins, while alternately broadening the veins with angioplasty balloons.
Because of complications, Randall's now in a wheelchair to avoid any pressure on her leg. She'll have to wait until her leg completely heals before she can resume training, Randall said. Her doctors told her she needs to remain on blood-thinning medication for the next six months.
Another contributing factor to her medical problems, according to SkiRacing.com, is a NuvaRing birth control device Randall began using in November, which has now been shown to increase the risk of serious blood clots 35 times in women with Factor V Leiden. Add in the long airplane trips Randall endures as a World Cup athlete — and the extended periods of sitting and inactivity on those trips that have been shown to contribute to potential clotting — and Randall’s doctors called it a “perfect storm” of risk factors that caught up to her all at once. Randall immediately stopped using the Nuva Ring and learned that a class action lawsuit against the makers of the device is being considered.
A graduate of East High, as well as first-ever American woman to win a World Cup race in cross-country skiing, Kikkan Randall learned two weeks ago that she also suffers from Factor V Leiden, a genetic disorder that increases her risk for dangerous blood clotting. Randall has her own personal blog on the FasterSkier website where she discusses these issues further. She also discusses her life and career on the Kikkan.com website. These medical complications are quite unfortunate, since she was busily and successfully training for the 2010 Winter Olympics, winning a sprint race during a March Canadian meet. Her skiing career must be considered on hold for the time being.
Kikkan Randall also became well-known throughout Alaska for the series of T.V. spots she did for Matanuska Maid, in exchange for their sponsorship. Randall's fresh-scrubbed look, winsome smile, and exemplary personal conduct may have deferred Matanuska Maid's collapse for at least a year.