Skip to main content
Erschienen in: Journal of Thrombosis and Thrombolysis 4/2023

06.03.2023

Treating a limb-threatening arterial clot in a newborn with catheter-directed thrombolysis

verfasst von: Grace Murray, Omri David Soffer, Rachel Taylor, Christopher Curzon, Chittalsinh Raulji

Erschienen in: Journal of Thrombosis and Thrombolysis | Ausgabe 4/2023

Einloggen, um Zugang zu erhalten

Abstract

Non-catheter related arterial thromboembolism in the neonatal population is rare and carries a significant risk of organ damage or limb loss. Thrombolysis, whether systemic or catheter- directed, is reserved either for limb or life-threatening thrombosis due to risk of bleeding especially in premature neonates. In this case, an infant male born at 34 weeks and 4 days gestational age presented with limb-threatening clot in the distal right subclavian artery and proximal right axillary artery with no known cause. After discussion of risks and benefits of various treatment options, he received thrombolysis treatment with low dose recombinant TPA via an umbilical artery catheter. There was complete resolution of the thrombus with this treatment and the patient had no significant bleeding while receiving treatment. Further investigation is needed to identify the patient population that will benefit from catheter-directed thrombolytic therapy and how to best monitor these patients.
Literatur
1.
Zurück zum Zitat Arshad A, McCarthy MJ (2009) Management of limb ischaemia in the neonate and infant. Eur J Vasc Endovasc Surg 38(1):61–65CrossRefPubMed Arshad A, McCarthy MJ (2009) Management of limb ischaemia in the neonate and infant. Eur J Vasc Endovasc Surg 38(1):61–65CrossRefPubMed
2.
Zurück zum Zitat Wang M, Hays T, Balasa V, Bagatell R, Gruppo R, Grabowski EF, Valentino L, Tsao-Wu G, Manco-Johnson MJ, Pediatric Coagulation Consortium (2003) Low-dose tissue plasminogen activator thrombolysis in children. J Pediatr Hematol Oncol 25(5):379–386CrossRefPubMed Wang M, Hays T, Balasa V, Bagatell R, Gruppo R, Grabowski EF, Valentino L, Tsao-Wu G, Manco-Johnson MJ, Pediatric Coagulation Consortium (2003) Low-dose tissue plasminogen activator thrombolysis in children. J Pediatr Hematol Oncol 25(5):379–386CrossRefPubMed
5.
Zurück zum Zitat Brotschi B, Hug MI, Latal B, Neuhaus D, Buerki C, Kroiss S, Spoerri C, Albisetti M (2011) Incidence and predictors of indwelling arterial catheter-related thrombosis in children. J Thromb Haemost 9(6):1157–1162CrossRefPubMed Brotschi B, Hug MI, Latal B, Neuhaus D, Buerki C, Kroiss S, Spoerri C, Albisetti M (2011) Incidence and predictors of indwelling arterial catheter-related thrombosis in children. J Thromb Haemost 9(6):1157–1162CrossRefPubMed
6.
Zurück zum Zitat Veenstra EB, van der Laan MJ, Zeebregts CJ, de Heide EJ, Kater M, Bokkers RPH (2020) A systematic review and meta-analysis of endovascular and surgical revascularization techniques in acute limb ischemia. J Vasc Surg 71(2):654–668CrossRefPubMed Veenstra EB, van der Laan MJ, Zeebregts CJ, de Heide EJ, Kater M, Bokkers RPH (2020) A systematic review and meta-analysis of endovascular and surgical revascularization techniques in acute limb ischemia. J Vasc Surg 71(2):654–668CrossRefPubMed
8.
Zurück zum Zitat Manco-Johnson MJ, Grabowski EF, Hellgreen M et al (2002) Recommendations for tPA thrombolysis in children. On behalf of the scientific subcommittee on perinatal and pediatric thrombosis of the scientific and standardization committee of the international society of thrombosis and haemostasis. Thromb Haemost. 88(1):157–158CrossRefPubMed Manco-Johnson MJ, Grabowski EF, Hellgreen M et al (2002) Recommendations for tPA thrombolysis in children. On behalf of the scientific subcommittee on perinatal and pediatric thrombosis of the scientific and standardization committee of the international society of thrombosis and haemostasis. Thromb Haemost. 88(1):157–158CrossRefPubMed
10.
Zurück zum Zitat Berger R, Bender S, Sefkow S, Klingmuller V, Kunzel W, Jensen A (1997) Peri/intraventricular haemorrhage: a cranial ultrasound study on 5286 neonates. Eur J Obstet Gynecol Reprod Biol 75(2):191–203CrossRefPubMed Berger R, Bender S, Sefkow S, Klingmuller V, Kunzel W, Jensen A (1997) Peri/intraventricular haemorrhage: a cranial ultrasound study on 5286 neonates. Eur J Obstet Gynecol Reprod Biol 75(2):191–203CrossRefPubMed
Metadaten
Titel
Treating a limb-threatening arterial clot in a newborn with catheter-directed thrombolysis
verfasst von
Grace Murray
Omri David Soffer
Rachel Taylor
Christopher Curzon
Chittalsinh Raulji
Publikationsdatum
06.03.2023
Verlag
Springer US
Erschienen in
Journal of Thrombosis and Thrombolysis / Ausgabe 4/2023
Print ISSN: 0929-5305
Elektronische ISSN: 1573-742X
DOI
https://doi.org/10.1007/s11239-023-02786-x

Weitere Artikel der Ausgabe 4/2023

Journal of Thrombosis and Thrombolysis 4/2023 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.