Digital substraction angiography (DSA) of the digital arteries

Digital substraction angiography (DSA) of the digital arteries In digital subtraction angiography one can see the discontinuation of the finger arteries 2-4.
Cause: Acute ischemia of the fingers after unintentional intra-arterial injection of flunitrazepam. This is a heroin-dependent patient, who dissolved the tablets in water beforehand.

therapy:

Digital subtraction angiography of the hand arteries

Combination treatment with heparin, prostaglandin, prednisolone and 10,000 IU tPA (alteplase) over an intra-arterial catheter, pain-control with opiates.

Complete reperfusion after 8 hours - consecutive compartment syndrome.

Cleavage of the compartments with neurolysis of the median nerve

Split skin transplant after 16 days