Case 04 (2024): Two cases of neonatal limb arterial thrombosis with thrombolytic therapy
10.3760/cma.j.cn113903-20240411-00280
- VernacularTitle:病例04（2024）：新生儿肢体动脉血栓溶栓治疗2例
- Author:
Mengze SUN
1
;
Ying ZHANG
;
Laishuan WANG
;
Zheng CHEN
;
Hua WANG
;
Xin DING
;
Qiushi WANG
;
Haidi HU
;
Ana HOU
Author Information
1. 中国医科大学附属盛京医院儿科，沈阳 110004
- Keywords:
Premature infants;
Neonates;
Arterial embolism;
Thrombolysis
- From:
Chinese Journal of Perinatal Medicine
2024;27(8):688-694
- CountryChina
- Language:Chinese
-
Abstract:
This article reported two cases of axillary artery thrombosis in extremely low/very low birth weight infants following the placement of a local arterial catheter, who hospitalized in Shengjing Hospital of China Medical Universityin in April 2023 and August 2022, respectively. Case 1: Before surgery for necrotizing enterocolitis, an arterial catheter was placed in the left axilla of the infant. On the same day, the infant developed cyanosis of the left upper limb and weakened radial artery pulse. Ultrasound examination confirmed the presence of left axillary artery thrombosis. Despite subcutaneous injection of low molecular weight heparin (LMWH) and plasma infusion, there was no improvement in blood circulation. The infant also exhibited reduced movement in the left upper limb and loss of radial artery pulse. Thrombolytic therapy with recombinant tissue-type plasminogen activator was administered. Six hours after the treatment, the radial artery pulse became palpable. Thrombolysis was then terminated, and anticoagulation with LMWH was supplied for two weeks. At one year and eight months of age, the infant had a weaker left-hand grip strength compared to the right, but the overall functionality was largely preserved. Case 2: The infant developed late-onset sepsis at 17 days old and had an arterial catheter placed in the axilla. Pale left upper limb was observed in the following day, and the brachial and radial artery pulses were absent. Vascular ultrasound indicated the presence of left axillary artery thrombosis. Anticoagulation therapy with subcutaneous injection of LMWH was provided, along with thrombolysis using urokinase. On the sixth day after thrombolysis, an ultrasound examination showed no thrombus-like echoes. At one year and eight months of age, the development and movement of the affected upper limb became normal.
