Fibrinolytic Treatment of Acute Digital Artery Occlusion in Upper Extremities: a case report

Abstract

A 79-year-old woman presented to our hospital with ischemic gangrene in the right little finger and with pain and cyanosis in the right index, middle, ring fingers. Intravenous injection of heparin and PGE1 was instituted without any clinical improvement. She underwent selective digital subtraction arteriography. An arteriogram revealed the occlusion of the digital artery. We initially treated the patient by continuous arterial administration of urokinase and heparin. After 5 days of fibrinolytic infusion, angiography showed resolution of the digital thrombi. The patient showed clinical improvement with the hand. We cautiously recommend fibrinolytic treatment for acute digital artery occlusion.