• Cardiovasc Intervent Radiol · Nov 2009

    Case Reports

    Treatment of bilateral hand frostbite using transcatheter arterial thrombolysis after papaverine infusion.

    • Arash M Saemi, Jason M Johnson, and Christopher S Morris.
    • Section of Interventional Radiology, Department of Radiology, University of Vermont College of Medicine and Fletcher Allen Health Care, Burlington, VT 05401, USA.
    • Cardiovasc Intervent Radiol. 2009 Nov 1; 32 (6): 1280-3.

    AbstractStandard therapy for frostbite has been unaltered for more than 20 years. Recently there have been reports of improved outcomes with the addition of a vasodilator to intra-arterial thrombolytic therapy. We report the case of severe frostbite of the hands successfully treated with transcatheter intra-arterial tPA after papaverine infusion in a 37-year-old man. Upper extremity and hand angiography within 16 h of the insult showed thrombotic occlusive disease and vasospasm. Intra-arterial catheters were placed in the brachial arteries and a papaverine infusion was initiated, followed by intra-arterial tPA thrombolysis. Follow-up examination at 4 months revealed full hand function and complete resolution of symptoms.

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