Abstract
Thromboembolic complications with umbilical artery catheters alone are estimated at 1% to 9%. Smaller and sicker infants suffer more complications due to catheterisation. Management of arterial thrombosis in the neonatal period remains controversial. Therapeutic options include elevation and warming of the affected limb, systemic anticoagulation with heparin, thrombolysis and surgical thrombectomy. Lytic therapy is often necessary to treat life and limb threatening arterial thrombi. Recombinant tissue plasminogen activator (r-TPA) has become the agent of choice for thrombolysis. The optimal use, dosage, efficacy, and bleeding toxicity of r-TPA in children are unknown. We report a small premature whom umbilical arterial catheterization complicated femoral artery occlusion with thrombus. She was treated successfully with r-TPA.
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