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Abnormalities of the fibrinolytic system as a cause of upper extremity ischemia: a preliminary report.

Abstract：

:Abnormalities of the fibrinolytic system can result in unusual or unexplained clotting that occurs spontaneously or after minor trauma. We identified five patients with limb-threatening arterial thrombosis of the upper extremity associated with either a low level of plasminogen or an abnormal immunoreactive plasminogen. All patients had extensive thrombosis of the brachial, radial, and ulnar arteries. Two patients had concomitant thrombus of the subclavian artery, which in one patient was associated with distal embolization to the hand. There was no evidence of atherosclerosis in any patient. Detection of an abnormal plasminogen level was done by immunoelectrophoresis of the patient's serum with antiplasminogen sera. In these patients a separate immunoreactive band located near the anode and distinct from the normal single plasminogen band was detected. Because of extensive thrombosis of the arterial system, exploration of the brachial artery, as well as the origin of all the forearm vessels, was necessary for complete balloon catheter thrombectomy. Prompt diagnosis and treatment are necessary to prevent the catastrophic complication of arm or hand amputation. Patients with an abnormal plasminogen level should receive perioperative heparin therapy and long-term warfarin to prevent recurrent thrombotic episodes.

journal_name

J Vasc Surg

journal_title

Journal of vascular surgery

authors

Towne JB,Hussey CV,Bandyk DF

doi

10.1067/mva.1988.avs0070661

subject

Has Abstract

pub_date

1988-05-01 00:00:00

pages

661-6

issue

5

eissn

0741-5214

issn

1097-6809

pii

0741-5214(88)90010-9

journal_volume

7

pub_type

杂志文章

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