Arterial occlusion in a preterm infant. Successful non-surgical treatment with urokinase and low-dose heparin.

Neonatal arterial occlusion is a rare condition of obscure aetiology, when not associated with catheterization of the umbilical artery. Embolic occlusion of the left iliac artery was diagnosed in a preterm baby weighing 1000 g, who presented with a cold, pale and pulseless left leg on the 6th day of life. Surgical embolectomy was contraindicated in this very small baby. Fibrinolytic therapy with urokinase and administration of low-dose heparin resulted in a complete recovery of skin colour, skin temperature and blood pressure. After three weeks of urokinase therapy, no pulse differences could be detected between right and left femoral and popliteal arteries by Doppler examination, and only minimal differences were present between right and left tibial arteries.