Doctors on Earth treated an astronaut’s blood clot in space

Grant Boone
January 6, 2020

An astronaut had a Deep Vein Thrombosis (DVT)-or called blood clot.

"My first reaction when NASA reached out to me was to ask if I could visit the International Space Station (ISS) to examine the patient myself", said in a statement Moll.

The identity is not disclosed due to privacy matters.

The astronaut was two months into a six-month mission when the clot was discovered.

NASA had no clue to treat the condition in an environment with zero gravity, as this is the first case that blood clot was discovered in space.

It might result in the International Space Station, the place an astronaut had a blood clot within the jugular vein.

"NASA told me they couldn't get me up to space quickly enough, so I proceeded with the evaluation and treatment process from here in Chapel Hill", said Moll.

UNC School of Medicine blood-clot expert Stephan Moll at NASA.

He and the staff agreed to place the astronaut on blood thinners with Moll directing the dosage.

If not for that body fluid study, however, there is no telling what could have happened.

The study sought to close gaps in knowledge about circulatory physiology that will not only benefit patients on Earth, but could be critical for the health of astronauts during future space exploration missions to the moon and Mars.

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However, the risks of using a blood thinner on the astronaut included an increased chance of bleeding, which also isn't ideal when you're nowhere near a hospital.

Four days before returning home to Earth, the astronaut ended their pill program at the behest of NASA's medical team, anxious about the physical demands and potential dangers of re-entry.

'In either case, emergency medical attention could be needed.

They only had an injection based version of the drug they chose to use - Enoxaparin - on board the station and only enough to last 40 days at the dosage prescribed by Dr Moll. On the 43 day of the astronaut's treatment, an unspecified resupply cargo spacecraft arrived at the ISS, bringing Apixaban, a pill taken orally.

"When the astronaut called my home phone, my wife answered and then passed the phone to me with the comment, 'Stephan, a phone call for you from space.' That was pretty fantastic", says Moll. "And amazingly the call connection was better than when I call my family in Germany".

The full treatment lasted 90 days and also involved the astronaut performing ultrasounds on their own neck with guidance from radiologists on Earth.

The astronaut stopped taking the medication four days before their return to Earth due to the potential danger of re-entry.

Despite the good news, the authors of the paper say the experience should serve as an important lesson about the many unknowns of space travel.

'How do you minimize risk for DVT?

Researchers from the Louisiana State University (LSU) in the USA assessed eleven astronauts involved in the vascular study during a long-duration mission. The team of doctors decided that space travel is unsafe enough and physically demanding, they didn't want to take a chance. Should there be more medications for it kept on the ISS?', said Dr Moll.

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