title: The role of thrombolytics in acute and chronic occlusion of the hand.
abstract: Distal arm and hand ischemia from vessel thrombosis or embolism remains a difficult clinical challenge. The causes of ischemia are variable and include connective tissue disease, embolism, atherosclerosis, and iatrogenic etiology. Although reports are limited, treatment with catheter-directed thrombolysis has favorable results in cases of acute thrombosis, with most patients (80%) demonstrating improvement. Digital amputation rates are less than 10% and the hand is often salvaged. Bleeding and access-site complications remain prevalent in patients undergoing intra-arterial thrombolysis. This review discusses etiology, treatment approaches, outcomes, and complications when thrombolytic therapy is used for distal arm and hand ischemia.
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address: demartino.randall@mayo.edu.
authors.forename: Randall R
authors.initials: RR
authors.lastname: De Martino
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Moran
mesh_terms: D000208:Acute Disease; D000792:Angiography; D002908:Chronic Disease; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006225:Hand / Q000098:blood supply* / Q000000981:diagnostic imaging; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Arterial occlusion; Catheter; Hand ischemia; Thrombolysis; Thrombolytics