In utero brachial artery thrombosis: limb salvage with postnatal urokinase infusion.
In utero brachial artery thrombosis leading to neonatal extremity gangrene can occur from a variety of causes. Traditional management has been limited to supportive care, often leading to early amputation. We report a case of a 1-day-old neonate who presented with an in utero brachial artery thrombosis and whose treatment consisted of early, aggressive systemic thrombolytic therapy followed by serial soft-tissue debridement and ultimate skin coverage through cultured epithelial autografts. This resulted in a successfully salvaged and partially functional upper extremity.
Ricciardelli
E
E
Department of Plastic Surgery and Orthopedics, University of Virginia Health Sciences Center, Charlottesville 22908.
Morgan
R F
RF
Lin
K Y
KY
D001132:Arm / Q000473:pathology*; D001916:Brachial Artery; D005260:Female; D005315:Fetal Diseases; D005734:Gangrene / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D009336:Necrosis; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000151:congenital* / Q000628:therapy*; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
D014568:Urokinase-Type Plasminogen Activator