Clot-Busting Drugs Open Blocked Arteries

The people in a recent prospective trial had severely frostbitten hands and feet. Typically this leads to gangrene and loss of limbs. In severe frostbite, the blood vessels are affected and blood flow is blocked. After thawing and re-warming, small clots form. Spasm of the injured arteries further impedes flow to the smallest vessels of the limbs. The standard treatment for frostbite—typically involving re-warming the affected area and, in severe cases, amputation—hasn’t changed for decades.

Interventional radiologists used angiography, an X-ray exam of the arteries and veins, to confirm loss of blood flow to a patients hand or toes, then intra-arterial catheters to directly deliver drugs to dissolve the blood clots and relax the arteries’ muscular walls. This treatment was significantly successful in preventing amputation and saving limbs, according to a new study.

“We were able to reopen even the smallest arteries, saving patients’ fingers and toes,” said George R. Edmonson, M.D., interventional radiologist with St. Paul Radiology in St. Paul, Minn. According to Edmonson, severe frostbite or “freezeburn” looks like a second degree heat burn with large blisters, but it’s actually body tissue that’s been frozen and—in severe cases—dead, he said.

In this small prospective trial, results from six frostbite patients, ages 18–65 years, who received Tenectaplase were compared with 11 individuals who had received Retaplase. The trial was designed to see if the greater plasma stability of Tenectaplase would lead to better results. “With both groups, approximately 80 percent of the patients’ affected limbs, fingers and toes responded with significant improvement,” noted Edmonson.

MEDICA.de; Quelle: Society of International Radiology