iloprost and Emergencies

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.. 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.. 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.. Ischemia of an extremity after intraarterial injection of drugs is a vascular emergency.

Topics: Acute Disease; Adult; Amputation, Surgical; Anti-Inflammatory Agents; Anticoagulants; Central Nervous System Stimulants; Drug Therapy, Combination; Emergencies; Fingers; Heparin; Humans; Iloprost; Injections, Intra-Arterial; Ischemia; Male; Methylphenidate; Necrosis; Platelet Aggregation Inhibitors; Prednisone; Prostaglandins; Radial Artery; Substance Abuse, Intravenous