title: Thrombolysis and thromboaspiration for acute thromboembolic occlusion in the upper extremity.
abstract: OBJECTIVE
  To report technical aspects of thrombolysis and thromboaspiration for acute thromboembolic occlusion in the upper extremity.
  
  
  METHODS
  This study included four consecutive patients with acute thromboembolic occlusion in the upper extremity (right arm, n = 3; left arm n = 1). The mean patient age was 81.3 ± 11.5 years (mean ± standard deviation; range 69-92 years) and all patients had chronic atrial fibrillation. Emergent angiography was performed via the femoral artery.
  
  
  RESULTS
  Thromboembolic occlusion was demonstrated in the axillary artery (n = 2), axillary and radial arteries (n = 1), and brachial, radial, and ulnar arteries (n = 1). Endovascular treatment was performed via the unaffected brachial (n = 3) or radial artery (n = 1). Thrombolysis was performed for three patients using 360,000-480,000 IU (mean 400,000 ± 69,000 IU) urokinase, including 12-h continuous infusion in one. Thromboaspiration was performed in all four patients using a 6F catheter. Recanalization was achieved in all patients and all arms were salvaged. Perforation of the small branch during guidewire manipulation was successfully managed by placement of a microcoil.
  
  
  CONCLUSIONS
  The combination of thrombolysis and thromboaspiration is effective for acute thromboembolic occlusion in the upper extremity.
authors.affiliation: Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, 7-1 Funabashi, Wadanaka-cho, Fukui, 918-8503, Japan. s-miyayama@fukui.saiseikai.or.jp
authors.forename: Shiro
authors.initials: S
authors.lastname: Miyayama
authors.forename: Masashi
authors.initials: M
authors.lastname: Yamashiro
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Shibata
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hashimoto
authors.forename: Miki
authors.initials: M
authors.lastname: Yoshida
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Tsuji
authors.forename: Fumihito
authors.initials: F
authors.lastname: Toshima
authors.forename: Osamu
authors.initials: O
authors.lastname: Matsui
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000098:blood supply*; D057510:Endovascular Procedures; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D013396:Suction; D013923:Thromboembolism / Q000188:drug therapy / Q000628:therapy*; D015912:Thrombolytic Therapy; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D014568:Urokinase-Type Plasminogen Activator