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

Acute ischemia of the fingers after unintentional intra-arterial injection of flunitrazepamCause:
Acute ischemia of the fingers after unintentional intra-arterial injection of flunitrazepam. The patient is a heroin addict, 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