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J Reconstr Microsurg 1996; 12(8): 539-542
DOI: 10.1055/s-2007-1006626
ORIGINAL ARTICLE

© 1996 by Thieme Medical Publishers, Inc.

Microvascular and Thrombolytic Revascularization of an Arm in a 32-Week-Gestation Neonate:Case Report and Review of the Literature

R. J.W. Theile, C. J. Coombs
  • Department of Plastic and Maxillofacial Surgery, Royal Children's Hospital, Melbourne, Australia
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Publication History

Accepted for publication 1996

Publication Date:
08 March 2008 (online)

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ABSTRACT

A 2300-g pre-term neonate with severe hyaline membrane disease experienced right forearm and hand ischemia following a brachial arterial line insertion. Limb salvage was achieved through combined micro-surgical exploration and thrombectomy of the brachial and radial arteries, with postoperative regional infusion of tissue plasminogen activator (TPA) through the distal radial artery for 48 hr, to dissolve a thrombus within the small vessels of the hand. This report advocates combined surgical and regional thrombolytic therapy with tissue plasminogen activator as management for neonatal arterial thrombosis and limb ischemia.