Arterial Interventions and Peripheral Arterial Disease (PAD)

Session: Educational Exhibit Presentations - Station 1: Arterial Interventions and Peripheral Arterial Disease (PAD)

Endovascular Treatment of Extremity Frostbite

Monday, March 6, 2023

5:25 PM – 5:30 PM

Location: Phoenix Convention Center, North Ballroom 120ABC, Poster Hall

Abstract Presenter(s)

AR

Abhay Raina, MD

Resident Physician
Texas Tech Health Science Center at El Paso

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

SR

Seunghong Rhee, MD

Resident Physician
Texas Tech Health Science Center at El Paso
AP

Austin Promersberger, n/a

Medical Student
University of North Dakota
MT

Mitchell Thelen, n/a

Medical Student
University of North Dakota
AS

Agnieszka Solberg, MD (she/her/hers)

Vascular and Interventional Radiologist
RadCX

Disclosure(s):

Abhay Raina, MD: No financial relationships to disclose

Agnieszka Solberg, MD: No financial relationships to disclose

Learning Objectives:

Familiarize the Society of Interventional Radiology with initial evaluation and management of frostbite injury.

Present several cases of extremity thrombolysis in the setting of frostbite injury.

Review the current evidence for endovascular management of extremity frostbite injuries.

Background:

Severe frostbite injury causes ischemia and can lead to significant morbidity resulting from tissue loss and amputation. Though randomized, prospective trials are lacking, there is a growing body of evidence supporting endovascular thrombolysis in the management of frostbite injuries. Depending on the location of vascular and interventional radiology (VIR) training, it is likely that the majority of graduating VIRs have no experience in assessing a patient with frostbite. We hope to familiarize VIRs with the literature supporting the endovascular management of frostbite and share our local protocols which can be adapted to other institutions.

Clinical Findings/Procedure Details:

Review frostbite injury classification systems.

Outline our institutional workflow for endovascular management of frostbite injuries including pre-procedural work-up, procedural details including our thrombolysis infusion protocol, and roles of collaborating services.

Evaluate the literature comparing varied thrombolysis regiments and their efficacy.

Present several cases of endovascular treatment of frostbite injuries including photos and angiographic images.

Conclusion and/or Teaching Points:

All VIRs should have the technical skills to perform extremity thrombolysis in the setting of severe frostbite injury.

Learning to classify and evaluate frostbite injuries is imperative if participating in the care of these patients.

An institutional algorithm can be helpful in the management of uncommonly encountered injuries such as severe frostbite.