title: Treatment of bilateral hand frostbite using transcatheter arterial thrombolysis after papaverine infusion.
abstract: Standard therapy for frostbite has been unaltered for more than 20 years. Recently there have been reports of improved outcomes with the addition of a vasodilator to intra-arterial thrombolytic therapy. We report the case of severe frostbite of the hands successfully treated with transcatheter intra-arterial tPA after papaverine infusion in a 37-year-old man. Upper extremity and hand angiography within 16 h of the insult showed thrombotic occlusive disease and vasospasm. Intra-arterial catheters were placed in the brachial arteries and a papaverine infusion was initiated, followed by intra-arterial tPA thrombolysis. Follow-up examination at 4 months revealed full hand function and complete resolution of symptoms.
authors.affiliation: Section of Interventional Radiology, Department of Radiology, University of Vermont College of Medicine and Fletcher Allen Health Care, Burlington, VT 05401, USA.
authors.forename: Arash M
authors.initials: AM
authors.lastname: Saemi
authors.forename: Jason M
authors.initials: JM
authors.lastname: Johnson
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Morris
mesh_terms: D000328:Adult; D000792:Angiography; D005627:Frostbite / Q000188:drug therapy*; D006225:Hand / Q000098:blood supply*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D010208:Papaverine / Q000008:administration & dosage / Q000627:therapeutic use*; D020127:Recovery of Function; D015912:Thrombolytic Therapy / Q000379:methods*; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents; D010208:Papaverine