• D M Widlus, A C Venbrux, J F Benenati, S E Mitchell, A Lynch-Nyhan, F P Cassidy, and F A Osterman.
• Russell H. Morgan Department of Radiology and Radiologic Sciences, Johns Hopkins Medical Institutions, Baltimore, MD 21205-2191.
• Radiology. 1990 May 1; 175 (2): 393-9.

AbstractAcute upper-extremity arterial occlusion may be due to embolic phenomena or de novo thrombosis. If the occlusion is left untreated, claudication or ischemia necessitating amputation can occur. Operative Fogarty-balloon embolectomy has been the treatment of choice for this entity. In a 6-year period the authors used fibrinolysis on nine occasions in eight patients to treat acute upper-extremity arterial occlusions. Concomitant balloon angioplasty was helpful in four cases. Success, defined as a normal hand with at least one artery that was continuously patent to the wrist, was achieved in all patients. A single significant groin hematoma was seen. Neither stroke nor death occurred in any case, and no amputations were necessary. Local transcatheter intraarterial administration of urokinase can be considered a first-line treatment for brachial artery embolus and other causes of acute upper-extremity arterial occlusion.

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