Intraarterial drug abuse: new treatment options.
Accidental, intraarterial injections of abused substances continue to be difficult management problems because of severe vascular complications. Vasospasm probably plays an important role in the pathophysiology of this injury, in addition to the more accepted roles of thrombosis and endarteritis. Three patients with severe, upper extremity ischemia after intraarterial injection of heroin, methamphetamine, and meperidine were treated with intraarterial tolazoline and streptokinase, along with intravenous heparin. All three patients had improved perfusion, assessed both clinically and by angiography. The responses to treatment in these patients demonstrated the roles of vasospasm and thrombosis in the origin of this injury and the therapeutic benefits of appropriately administered vasodilators and thrombolytic agents.
Silverman
S H
SH
Department of Surgery, University of Texas Southwestern Medical Center, Dallas.
Turner
W W
WW
D000328:Adult; D000792:Angiography; D001132:Arm / Q000098:blood supply*; D001916:Brachial Artery; D005260:Female; D006225:Hand / Q000098:blood supply; D003932:Heroin / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007269:Injections, Intra-Arterial / Q000009:adverse effects*; D007511:Ischemia / Q000139:chemically induced / Q000188:drug therapy*; D008297:Male; D008614:Meperidine / Q000008:administration & dosage / Q000009:adverse effects; D008694:Methamphetamine / Q000008:administration & dosage / Q000009:adverse effects; D015819:Substance Abuse, Intravenous; D014043:Tolazoline / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use
D014665:Vasodilator Agents; D008694:Methamphetamine; D003932:Heroin; D008614:Meperidine; D014043:Tolazoline