Fibrinolytic therapy for upper-extremity arterial occlusions.

Abstract

Acute upper-extremity arterial occlusion may be due to embolic phenomena or de novo thrombosis. If the occlusion is left untreated, claudication or ischemia necessitating amputation can occur. Operative Fogarty-balloon embolectomy has been the treatment of choice for this entity. In a 6-year period the authors used fibrinolysis on nine occasions in eight patients to treat acute upper-extremity arterial occlusions. Concomitant balloon angioplasty was helpful in four cases. Success, defined as a normal hand with at least one artery that was continuously patent to the wrist, was achieved in all patients. A single significant groin hematoma was seen. Neither stroke nor death occurred in any case, and no amputations were necessary. Local transcatheter intraarterial administration of urokinase can be considered a first-line treatment for brachial artery embolus and other causes of acute upper-extremity arterial occlusion.

• Authors: D M Widlus, A C Venbrux, J F Benenati, S E Mitchell, A Lynch-Nyhan, F P Cassidy Jr, F A Osterman Jr
• Journal: Radiology (Radiology) Vol. 175 Issue 2 Pg. 393-9 (May 1990) ISSN: 0033-8419 [Print] United States
• PMID: 2326466 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Angiography
• Arm (blood supply)
• Axillary Artery (diagnostic imaging)
• Brachial Artery (diagnostic imaging)
• Embolism (diagnostic imaging, etiology, therapy)
• Female
• Humans
• Male
• Middle Aged
• Subclavian Artery (diagnostic imaging)
• Thrombolytic Therapy (adverse effects)
• Thrombosis (diagnostic imaging, etiology, therapy)