Abstract
History and clinical findings:
A 36-year-old patient presented with a severe hand ischemia after intraarterial injection of four dissolved tablets of Methylphenidate each 10 mg (Ritalin into the right radial artery.
Investigations:
Non-invasive vascular diagnostic demonstrated a normal perfusion of the radial and ulnar artery and a severe ischemia of the small vessels of the right hand.
Treatment and course:
Under suspicion of a combined vaso-spastic and thromboembolic arterial occlusion we started an intraarterial lysis therapy followed by anticoagulation with heparin and infusions of prostaglandines. Despite this therapy necroses of three fingers developed; partial amputation was followed by a good wound healing.
Conclusions:
Ischemia of an extremity after intraarterial injection of drugs is a vascular emergency.
Publication types
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Case Reports
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Comparative Study
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English Abstract
MeSH terms
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Acute Disease
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Adult
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Amputation, Surgical
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Anti-Inflammatory Agents / administration & dosage
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Anti-Inflammatory Agents / therapeutic use
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Anticoagulants / administration & dosage
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Anticoagulants / therapeutic use
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Central Nervous System Stimulants / administration & dosage
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Central Nervous System Stimulants / adverse effects*
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Drug Therapy, Combination
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Emergencies
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Fingers / blood supply*
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Fingers / pathology
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Fingers / surgery
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Heparin / therapeutic use
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Humans
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Iloprost / administration & dosage
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Iloprost / therapeutic use
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Injections, Intra-Arterial / adverse effects*
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Ischemia / chemically induced*
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Ischemia / diagnosis
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Ischemia / drug therapy
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Ischemia / pathology
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Ischemia / surgery
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Male
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Methylphenidate / administration & dosage
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Methylphenidate / adverse effects*
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Necrosis
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Platelet Aggregation Inhibitors / administration & dosage
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Platelet Aggregation Inhibitors / therapeutic use
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Prednisone / administration & dosage
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Prednisone / therapeutic use
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Prostaglandins / administration & dosage
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Prostaglandins / therapeutic use
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Radial Artery*
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Substance Abuse, Intravenous*
Substances
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Anti-Inflammatory Agents
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Anticoagulants
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Central Nervous System Stimulants
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Platelet Aggregation Inhibitors
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Prostaglandins
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Methylphenidate
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Heparin
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Iloprost
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Prednisone