title: Acute brachial artery thrombosis in a neonate caused by a peripheral venous catheter.
abstract: This case describes the diagnostic testing and management of an acute thrombosis of the brachial artery in a female neonate. On day seven of life, clinical signs of acutely decreased peripheral perfusion indicated an occlusion of the brachial artery, which was confirmed by high-resolution Doppler ultrasound. Imaging also showed early stages of collateralization so that surgical treatment options could be avoided. Unfractionated heparin was used initially and then replaced by low-molecular-weight heparin while coagulation parameters were monitored closely. Within several days, brachial artery perfusion was completely restored. Acetylsalicylic acid was given for additional six weeks to minimize the risk of recurring thrombosis. If inadequately fixated in a high-risk location, a peripheral venous catheter can damage adjacent structures and thus ultimately cause arterial complications.
authors.affiliation: Department of Neonatology, GFO-Hospitals Bonn, St Mary's Hospital, Robert-Koch Street 1, 53115 Bonn, Germany.
authors.forename: Simon
authors.identifier: 0000-0003-2723-1629
authors.initials: S
authors.lastname: Berzel
authors.affiliation: Department of Vascular Surgery, GFO-Hospitals Bonn, St Mary's Hospital, Bonn, Germany ; Department of Cardiology, Pulmonology and Angiology, University Medical Centre, Dusseldorf, Germany.
authors.forename: Emilia
authors.identifier: 0000-0003-2407-2837
authors.initials: E
authors.lastname: Stegemann
authors.affiliation: Department of Experimental Hematology and Transfusion Medicine, University Medical Centre, Bonn, Germany.
authors.forename: Hans-Joerg
authors.initials: HJ
authors.lastname: Hertfelder
authors.affiliation: Department of Neonatology, GFO-Hospitals Bonn, St Mary's Hospital, Robert-Koch Street 1, 53115 Bonn, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Schneider
authors.affiliation: Department of Neonatology, GFO-Hospitals Bonn, St Mary's Hospital, Robert-Koch Street 1, 53115 Bonn, Germany.
authors.forename: Nico
authors.identifier: 0000-0001-5516-1168
authors.initials: N
authors.lastname: Hepping
references.citation: Acta Haematol. 2006;115(3-4):137-40
references.pmid: 16549887
references.citation: Thromb Haemost. 2012 May;107(5):827-37
references.pmid: 22437808
references.citation: Pediatrics. 1995 Nov;96(5 Pt 1):939-43
references.pmid: 7478839
references.citation: Chest. 2012 Feb;141(2 Suppl):e737S-e801S
references.pmid: 22315277
references.citation: Adv Neonatal Care. 2003 Oct;3(5):230-40
references.pmid: 14648520
references.citation: Semin Thromb Hemost. 2003 Aug;29(4):425-32
references.pmid: 14517754
references.citation: Br J Haematol. 2010 Aug;150(3):259-77
references.pmid: 20528873