Intra-arterial fibrinolysis for the management of acute ischemia on a below-knee amputation stump. Case report

• Autor(a) principal: Affonso,Breno Boueri
• Data de Publicação: 2018
• Outros Autores: Leal Filho,Joaquim Maurício da Motta, Cavalcante,Rafael Noronha, Falsarella,Priscila Mina, Galastri,Francisco Leonardo, Cardoso,Rodolfo Souza, Nasser,Felipe
• Tipo de documento: Relatório
• Idioma: eng
• Título da fonte: Einstein (São Paulo)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082018000100503
• topic: Fibrinolysis; Ischemia; Amputation stumps; Case reports

ABSTRACT Preservation of the knee joint has enormous advantages in terms of mobility and rehabilitation of an amputee. Any cause of breakdown requiring revision to an above-knee amputation is a major setback because it reduces the patient’s rehabilitative potential. We report a case of intra-arterial thrombolysis use to save a below-knee amputation stump with acute ischemia. A 56-year-old man who sought the emergency department with 1-day history of acute pain on his right below-knee stump. The angiography confirmed popliteal artery occlusion. Pharmacomechanical thrombectomy, with Aspirex (rotational catheter to restore blood flow in occluded vessel, by removing occlusion material from the vessel) and recombinant tissue plasminogen activator, was performed. After 9 years of follow-up the patient remained asymptomatic, capable of independent ambulation with prosthetic limb. Intra-arterial fibrinolysis seems to be a safe and effective treatment for cases of acutely ischemic amputation stump.