Acute ischemia of the fingers after unintentional intra-arterial injection of flunitrazepam 3 weeks after surgery

Acute ischemia of the fingers after unintentional intra-arterial injection of flunitrazepam 3 weeks after surgeryFinal result: After intra-arterial combined therapy a complete reperfusion was achieved again.
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