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Limb-threatening lower extremity ischemia successfully treated with intra-arterial infusion--case reports.

Abstract
The authors present two patients with acute arterial vasospasm of the lower extremities causing marked ischemia. One patient had a history of Raynaud's disease, the second had been taking Cafergot for migraine headaches. Both patients's were given a test dose of intra-arterial tolazoline (50 mg). The patient with Raynaud's disease demonstrated marked improvement diffusely and was successfully treated with overnight infusion of papaverine. The second patient, taking Cafergot, demonstrated no angiographic response to tolazoline. It was speculated that the arteries of this patient were thrombosed. The patient was successfully treated with urokinase and remained free of pain at the 15-month follow-up.
AuthorsM J D'Amore, M A Borge, R N Messersmith
JournalAngiology (Angiology) Vol. 50 Issue 3 Pg. 233-7 (Mar 1999) ISSN: 0003-3197 [Print] United States
PMID10088803 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Central Nervous System Stimulants
  • Drug Combinations
  • Vasoconstrictor Agents
  • Vasodilator Agents
  • caffeine, ergotamine drug combination
  • Caffeine
  • Tolazoline
  • Papaverine
  • Plasminogen Activators
  • Urokinase-Type Plasminogen Activator
  • Ergotamine
Topics
  • Adult
  • Caffeine (therapeutic use)
  • Central Nervous System Stimulants (therapeutic use)
  • Drug Combinations
  • Ergotamine (therapeutic use)
  • Female
  • Follow-Up Studies
  • Humans
  • Infusions, Intra-Arterial
  • Ischemia (drug therapy)
  • Leg (blood supply)
  • Middle Aged
  • Migraine Disorders (complications, drug therapy)
  • Papaverine (administration & dosage, therapeutic use)
  • Peripheral Vascular Diseases (drug therapy)
  • Plasminogen Activators (administration & dosage, therapeutic use)
  • Raynaud Disease (complications)
  • Thrombosis (complications, drug therapy)
  • Tolazoline (administration & dosage, therapeutic use)
  • Urokinase-Type Plasminogen Activator (administration & dosage, therapeutic use)
  • Vasoconstrictor Agents (therapeutic use)
  • Vasodilator Agents (administration & dosage, therapeutic use)

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