de-Ajayi, N; Hall, NJ; Liesner, R; Kiely, EM; Pierro, A; Roebuck, DJ; Drake, DP; (2008) Acute neonatal arterial occlusion: is thrombolysis safe and effective? J Pediatr Surg , 43 (10) 1827 - 1832.
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PURPOSE: We report our experience of the management of arterial occlusion in the newborn. METHODS: A case note review was carried out after ethical approval. Doppler ultrasonography confirmed the occlusion. Thrombolysis was the primary intervention. Surgery was used selectively. A good outcome was one without tissue loss or functional impairment or minimal tissue loss without functional impairment. Data are presented as medians with ranges. RESULTS: Ten patients (9 male; median gestational age, 35.5 weeks [range, 28-39 weeks]) presented on day 1 (range, 1-8 days). Initial management included systemic tissue plasminogen activator (8 patients) and surgery (2 infants in whom thrombolysis was contraindicated). Improvement was noted in 7 of 8 infants treated medically and in both who underwent surgery. Three infants had significant tissue loss. Outcome at 29 months (range, 1.3-95.4 months) was good in the remaining 7. CONCLUSIONS: A multidisciplinary approach, thrombolysis and selective surgery achieved tissue preservation and function in the majority while minimizing complications. Early referral to centers with multidisciplinary teams is recommended
|Title:||Acute neonatal arterial occlusion: is thrombolysis safe and effective?|
|Additional information:||DA - 20081017IS - 1531-5037 (Electronic)LA - engPT - Journal ArticleSB - IM|
|Keywords:||Child, Male, methods|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Child Health > Department of Nutritional and Surgical Science > ICH - Surgery Unit|
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