New Procedures Save Frostbite Victims from Amputation

The standard treatment for frostbite has not changed in decades—re-warming the affected areas, with amputation in severe cases. Radiologists can now re-open recently frozen, clotted arteries with clot-busting and anti-spasmodic drugs, using imaging to visualize areas lacking blood flow and deliver drugs via catheter.

With severely frostbitten hands and feet, subjects in a recent test would typically lose their limbs to gangrene. In this case, Angiography, an X-ray exam of the arteries and veins, was used by interventional radiologists to verify loss of blood flow to a patient’s hand or toes. Intra-arterial catheters then supplied drugs to dissolve the blood clots and relax the arteries’ muscular walls.

A study released today at the Society of Interventional Radiology’s 33rd Annual Scientific Meeting confirmed that this treatment was significantly successful in preventing amputation and saving limbs.

"Previously severe frostbite was a one-way route to limb loss. This treatment is a significant improvement. We’re opening arteries that are blocked so that tissues can heal and limbs can be salvaged. We were able to reopen even the smallest arteries, saving patients’ fingers and toes," said George R. Edmonson, M.D., interventional radiologist with St. Paul Radiology in St. Paul, Minnesota.

According to Edmonson, severe frostbite or "freezeburn" looks like a second degree heat burn with large blisters, but it’s actually body tissue that’s been frozen and-in severe cases-dead, he said. "For half our patients who received the clot-busting drug Tenectaplase, this technique worked beautifully, saving all fingers, hands, toes and feet that otherwise would have been lost," said Edmonson, who has been treating an average of 6–10 frostbite patients each year for the past 10 years.

"Overall, in about 80 percent of the cases, it significantly improved patients’ outcomes. Within one to three days of treatment, we saw improvement," noted Edmonson, explaining that patients were followed for six weeks to assess their final outcomes.

Source: Society for Interventional Radiology

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