[Acute ischemia after intraarterial drug injection].
METHODS
A 36-year-old patient presented with a severe hand ischemia after intraarterial injection of four dissolved tablets of Methylphenidate each 10 mg (Ritalin into the right radial artery.


METHODS
Non-invasive vascular diagnostic demonstrated a normal perfusion of the radial and ulnar artery and a severe ischemia of the small vessels of the right hand.


METHODS
Under suspicion of a combined vaso-spastic and thromboembolic arterial occlusion we started an intraarterial lysis therapy followed by anticoagulation with heparin and infusions of prostaglandines. Despite this therapy necroses of three fingers developed; partial amputation was followed by a good wound healing.


CONCLUSIONS
Ischemia of an extremity after intraarterial injection of drugs is a vascular emergency.
Thalhammer
C
C
Klinik für Angiologie, Universitätsspital, Basel, Schweiz. thalhammerc@uhbs.ch
Aschwanden
M
M
Kliem
M
M
Stürchler
M
M
Jäger
K A
KA
D000208:Acute Disease; D000328:Adult; D000671:Amputation, Surgical; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D004630:Emergencies; D005385:Fingers / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D016285:Iloprost / Q000008:administration & dosage / Q000627:therapeutic use; D007269:Injections, Intra-Arterial / Q000009:adverse effects*; D007511:Ischemia / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000009:adverse effects*; D009336:Necrosis; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D011453:Prostaglandins / Q000008:administration & dosage / Q000627:therapeutic use; D017534:Radial Artery; D015819:Substance Abuse, Intravenous
D000893:Anti-Inflammatory Agents; D000925:Anticoagulants; D000697:Central Nervous System Stimulants; D010975:Platelet Aggregation Inhibitors; D011453:Prostaglandins; D008774:Methylphenidate; D006493:Heparin; D016285:Iloprost; D011241:Prednisone