title: Thrombolytic therapy in the setting of arterial line-induced ischemia.
abstract: OBJECTIVE
  To evaluate the use of percutaneous transcatheter thrombolysis in the treatment of thrombosis due to radial artery cannulation.
  
  
  RESULTS
  Seven patients (4 women; age range 41-62 years) with symptomatic cannulation-induced thrombosis and failure to improve after systemic anticoagulation underwent 8 catheter-directed thrombolytic infusions at our institution over a 3-year period. Access was either antegrade through the brachial artery or retrograde through the femoral artery. Thrombolytic infusions with urokinase began 2 to 12 days (average 6) after removal of the radial artery catheter. The thrombolytic infusion was successful in 5 of 7 patients based on angiographic flow restoration with <20% residual thrombus and significant clinical improvement in the ischemia.
  
  
  CONCLUSIONS
  When systemic anticoagulation has failed, percutaneous catheter-directed thrombolytic infusion appears to be effective in the treatment of most patients with severe ischemic hand symptoms due to thrombosis after radial artery cannulation.
authors.affiliation: Department of Radiology, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA. jfg@jhmi.edu
authors.forename: Jean-François H
authors.initials: JF
authors.lastname: Geschwind
authors.forename: Mandeep S
authors.initials: MS
authors.lastname: Dagli
authors.forename: Drew L
authors.initials: DL
authors.lastname: Lambert
authors.forename: Hicham
authors.initials: H
authors.lastname: Kobeiter
mesh_terms: D000328:Adult; D002404:Catheterization / Q000009:adverse effects*; D005260:Female; D006225:Hand / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010960:Plasminogen Activators / Q000627:therapeutic use*; D017534:Radial Artery; D012189:Retrospective Studies; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000188:drug therapy* / Q000209:etiology; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator