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Fibrinolytic therapy for upper-extremity arterial occlusions
D M Widlus1, A C Venbrux, J F Benenati
1Russell H. Morgan Department of Radiology and Radiologic Sciences, Johns Hopkins Medical Institutions, Baltimore, MD 21205-2191.
Radiology
|May 1, 1990
Summary
Fibrinolysis, a minimally invasive treatment, effectively resolves acute upper-extremity arterial occlusions. This approach, sometimes combined with balloon angioplasty, offers a safe and successful alternative to surgery, preventing limb loss.
Area of Science:
- Vascular Surgery
- Interventional Radiology
Background:
- Acute upper-extremity arterial occlusion presents a significant risk of limb ischemia and amputation.
- Traditional treatment involves operative Fogarty-balloon embolectomy, which carries surgical risks.
Purpose of the Study:
- To evaluate the efficacy and safety of fibrinolysis as a primary treatment for acute upper-extremity arterial occlusions.
- To compare fibrinolysis with traditional surgical embolectomy.
Main Methods:
- A retrospective review of eight patients treated with fibrinolysis over a six-year period.
- Local transcatheter intraarterial urokinase administration was the primary method, with concomitant balloon angioplasty in select cases.
Main Results:
- Successful treatment, defined as a patent artery to the wrist and a functional hand, was achieved in all patients.
- No strokes, deaths, or amputations occurred.
- A single instance of significant groin hematoma was the only major complication.
Conclusions:
- Local transcatheter intraarterial fibrinolysis is a safe and effective first-line treatment for acute upper-extremity arterial occlusions.
- This minimally invasive approach avoids the complications associated with surgical embolectomy and preserves limb function.