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[Acute ischemia after intraarterial drug injection]
C Thalhammer1, M Aschwanden, M Kliem
1Klinik für Angiologie, Universitätsspital, Basel, Schweiz. thalhammerc@uhbs.ch
History And Clinical Findings:
A 36-year-old patient presented with a severe hand ischemia after intraarterial injection of four dissolved tablets of Methylphenidate each 10 mg (Ritalin into the right radial artery.
Investigations:
Non-invasive vascular diagnostic demonstrated a normal perfusion of the radial and ulnar artery and a severe ischemia of the small vessels of the right hand.
Treatment And Course:
Under suspicion of a combined vaso-spastic and thromboembolic arterial occlusion we started an intraarterial lysis therapy followed by anticoagulation with heparin and infusions of prostaglandines. Despite this therapy necroses of three fingers developed; partial amputation was followed by a good wound healing.
Conclusions:
Ischemia of an extremity after intraarterial injection of drugs is a vascular emergency.