Fibrinolytic therapy for upper-extremity arterial occlusions

D. M. Widlus, A. C. Venbrux, J. F. Benenati, S. E. Mitchell, A. Lynch-Nyhan, F. P. Cassidy, F. A. Osterman

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)393-399
Number of pages7
JournalRADIOLOGY
Volume175
Issue number2
DOIs
StatePublished - 1990

Keywords

  • arteries, extremities
  • arteries, stenosis or obstruction
  • extremities, thrombosis
  • fibrinolysis
  • streptokinase
  • thrombosis, arterial
  • urokinase

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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