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Continuous local intraarterial infusion after prolonged arterial stasis in the fingers and toes
Author(s) -
Fukui Akihiro,
Maeda Masami,
Mine Takako,
Inada Yuji,
Mizumoto Shigeru,
Tamai Susumu
Publication year - 1992
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.1920130203
Subject(s) - medicine , urokinase , venous stasis , heparin , surgery , anesthesia , prostaglandin e1 , fibrinolytic agent , antithrombotic
Abstract Seven patients with trauma to eight digits and one toe went untreated for arterial stasis, with subsequent development of posttraumatic changes in skin coloration. In two patients involving two digits, a daily dose of 2,000 ml containing 240,000 U urokinase, 80 μg prostaglandin E 1 , and 10,000 U heparin in lactated Ringer's solution was administered by intravenous infusion for 10 consecutive days; one of the two digits became necrotic. In all subsequent patients, a daily dose of 80 ml containing 240,000 U urokinase, 40 μg prostaglandin E 1 , 10,000 U (maximum) heparin, and low‐molecular‐weight dextran was administered by continuous local intraarterial infusion for 10 consecutive days. These seven extremities survived, even in the case of two digits and one toe with over 50 hr of arterial stasis. We believe that revascularization of extremities following prolonged periods of arterial stasis may be possible by means of continuous local intraarterial infusion of antithrombotic agents. © Wiley‐Liss, Inc.