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Acute neonatal arterial occlusion: is thrombolysis safe and effective?



Acute neonatal arterial occlusion: is thrombolysis safe and effective?



Journal of Pediatric Surgery 43(10): 1827-1832



We report our experience of the management of arterial occlusion in the newborn. A case note review was carried out after ethical approval. Doppler ultrasonography confirmed the occlusion. Thrombolysis was the primary intervention. Surgery was used selectively. A good outcome was one without tissue loss or functional impairment or minimal tissue loss without functional impairment. Data are presented as medians with ranges. Ten patients (9 male; median gestational age, 35.5 weeks [range, 28-39 weeks]) presented on day 1 (range, 1-8 days). Initial management included systemic tissue plasminogen activator (8 patients) and surgery (2 infants in whom thrombolysis was contraindicated). Improvement was noted in 7 of 8 infants treated medically and in both who underwent surgery. Three infants had significant tissue loss. Outcome at 29 months (range, 1.3-95.4 months) was good in the remaining 7. A multidisciplinary approach, thrombolysis and selective surgery achieved tissue preservation and function in the majority while minimizing complications. Early referral to centers with multidisciplinary teams is recommended.

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Accession: 051361159

Download citation: RISBibTeXText

PMID: 18926215

DOI: 10.1016/j.jpedsurg.2008.04.025


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