Low-dose fibrinolytic therapy in hand ischemia.

Intra-arterial, low-dose streptokinase therapy was administered to five patients with acute hand ischemia (2 to 48 hours' duration) and one patient with chronic hand ischemia (3 months' duration). In the five patients with acute ischemia excellent restoration of patency of occluded hand arteries was obtained, with complete recovery of hand function and avoidance of tissue loss despite the severity of these cases. In the remaining patient with an iatrogenic chronic occlusion, ischemia could not be relieved and bypass surgery was performed with satisfactory results noted at the 3-month follow-up examination. No complications were encountered during or after any of these procedures. The catastrophic consequences of hand ischemia, i.e., loss of limbs or digits, were avoided.