Prolonged use of tissue plasminogen activator for bilateral lower limb arterial occlusion in a neonate.
The authors report the case of a 29-week-gestation twin with very severe vascular compromise of both lower limbs secondary to premature twin-twin transfusion. A tissue plasminogen activator (tPA) infusion was used locally for 13 days with complete recovery of perfusion to both legs, demonstrated by serial angiograms, thereby avoiding bilateral amputation. There were no side effects as a result of the continuous administration of tPA. The authors therefore suggest that the benefits of thrombolysis from a local infusion of tPA in neonates may outweigh the potential risks. This case report thus supports the view that under certain circumstances infusion of tPA in neonates may offer significant benefits. J Pediatr Surg 36:654-656.
Great Ormond Street Hospital, London, England.
S
S
Watkins
M
M
Yunge
D
D
Jones
E
E
Kiely
A J
AJ
Petros
D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D004200:Diseases in Twins; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005330:Fetofetal Transfusion / Q000150:complications* / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007262:Infusions, Intravenous; D007866:Leg; D011247:Pregnancy; D012720:Severity of Illness Index; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal
D010959:Tissue Plasminogen Activator