Thrombolysis of a neonatal brachial artery thrombosis with tissue plasminogen activator.
OBJECTIVE
A case report is presented describing the use of tissue plasminogen activator (TPA) to dissolve a thrombosis in the brachial artery of a critically ill premature neonate. A short review of the literature is included.


METHODS
A premature infant with pulmonary hypertension is discovered to have a concomitant right brachial artery thrombosis. A debate ensued concerning the choice of medical management to pursue after surgical extirpation was ruled out. After review of the various alternatives both traditional and novel, a decision was made to utilize TPA.


RESULTS
After a continuous infusion of 0.1 mg/kg per hour for 15 hours, blood flow was established distal to the previously occluded right brachial artery. No untoward side-effects occurred during or subsequent to the treatment.


CONCLUSIONS
TPA proved to be an extremely useful medication for the relief of a brachial artery thrombosis in this patient. The theoretical advantages, as well as several anecdotal reports of its successful use, should hopefully stimulate a large multicenter study of its use in the neonatal population.
Grieg
A
A
Department of Pediatrics, New York Flushing Hospital Medical Center, USA.
D001916:Brachial Artery; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D008297:Male; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
D010959:Tissue Plasminogen Activator