title: Intra-arterial thrombolysis of acute hand ischaemia with or without microcatheter: preliminary experience and comparison with the literature.
abstract: OBJECTIVE
  This paper evaluates the indications, techniques, results, and complications of intra-arterial thrombolysis with or without a multihole microcatheter in three cases of acute hand ischaemia in comparison with the literature.
  
  
  METHODS
  Three men (mean age 39 years) with symptoms and signs of acute hand ischaemia (i.e. pain, pallor, cyanosis, decreased motor or sensory function) were studied with Doppler ultrasound and selective arteriography, which demonstrated acute clotting of wrist and/or hand arteries. They therefore underwent intra-arterial thrombolysis with the administration of urokinase and vasodilators and heparin if necessary, with (n=2) or without (n=1) multihole microcatheters.
  
  
  RESULTS
  In all three cases, partial or complete recanalisation of the occluded arteries was achieved, with almost complete remission of clinical symptoms and good recovery of hand function.
  
  
  CONCLUSIONS
  Percutaneous intra-arterial thrombolysis is an effective therapeutic approach in cases of acute hand ischaemia and is a valid alternative to surgical thrombectomy. Multihole microcatheters allow the thrombolytic agent to be distributed more evenly into the clot and may help to reduce reactive arterial spasm.
authors.affiliation: Struttura Complessa di Radiologia, Ospedale San Bassiano, Bassano del Grappa, Italy. giuliobarbiero@katamail.com
authors.forename: G
authors.initials: G
authors.lastname: Barbiero
authors.forename: D
authors.initials: D
authors.lastname: Cognolato
authors.forename: A
authors.initials: A
authors.lastname: Casarin
authors.forename: A
authors.initials: A
authors.lastname: Guarise
mesh_terms: D000208:Acute Disease; D000328:Adult; D002404:Catheterization / Q000379:methods; D006225:Hand / Q000098:blood supply*; D006230:Hand Injuries / Q000150:complications*; D006801:Humans; D007511:Ischemia / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D014568:Urokinase-Type Plasminogen Activator