Microvascular and thrombolytic revascularization of an arm in a 32-week-gestation neonate: case report and review of the literature

Journal of Reconstructive Microsurgery
R J Theile, C J Coombs

Abstract

A 2300-g pre-term neonate with severe hyaline membrane disease experienced right forearm and hand ischemia following a brachial arterial line insertion. Limb salvage was achieved through combined microsurgical exploration and thrombectomy of the brachial and radial arteries, with postoperative regional infusion of tissue plasminogen activator (TPA) through the distal radial artery for 48 hr, to dissolve a thrombus within the small vessels of the hand. This report advocates combined surgical and regional thrombolytic therapy with tissue plasminogen activator as management for neonatal arterial thrombosis and limb ischemia.

Citations

Sep 29, 2001·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·J L OlarteB R Totapally
Apr 28, 2006·Plastic and Reconstructive Surgery·Christopher J CoombsPaul Monagle
Aug 15, 2013·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Galit RashishUNKNOWN Thrombosis and Hemostasis in Newborns (THiN) Group
May 20, 1999·The Annals of Pharmacotherapy·M L GloverJ Wolfsdorf

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