{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T05:20:43Z","timestamp":1784784043540,"version":"3.55.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T00:00:00Z","timestamp":1562630400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,16]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Frostbite causes tissue damage through five major mechanisms, out of which two are amenable to treatment. The first-line treatment is rapid rewarming therapy using water at 40\u00b0C to 42\u00b0C, which addresses the formation of ice crystals in the intra and extra cellular compartments. The second mechanism is progressive tissue ischemia after rewarming and is only accessible to a second-line therapy represented by thrombolysis. This study aimed to determine the efficacy of thrombolysis. This is a single-center retrospective cohort study, where it was aimed to evaluate two groups of patients. A total of 18 patients were included in this study. Mean times between injury to thrombolytic therapy and admission to thrombolytic therapy was 26.04 hours (SD 13.6) and 9.65 hours (SD 9.89), respectively. All patients suffered injuries ranging from second-degree deep to third degree. The rate of patients having complete, partial, and no angiographic responses were 55.6%, 11.1%, and 33.3%, respectively. The main outcome of interest showed that 11 (61.1%) patients in total had amputations at different levels. Results showed that in the intervention group, five (55.6%) of the patients had amputations compared with six (66.7%) from the control group (P = .6) at comparable levels of amputation. The literature supports that the use of intra-arterial tissue plasminogen activator might be beneficial for severe cases of frostbites; however, it lacks of studies of major significance and results are often controversial. Our study has not shown statistically significant results on amputation levels and cannot support the hypothesis of efficacy of thrombolytic therapy.<\/jats:p>","DOI":"10.1093\/jbcr\/irz118","type":"journal-article","created":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T05:47:47Z","timestamp":1562651267000},"page":"907-912","source":"Crossref","is-referenced-by-count":12,"title":["Using Intra-arterial tPA for Severe Frostbite Cases. An Observational Comparative Retrospective Study"],"prefix":"10.1093","volume":"40","author":[{"given":"Mohamed Nazhat","family":"Al Yafi","sequence":"first","affiliation":[{"name":"Burn Unit, University of Montreal Hospital Centre, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel Alain","family":"Danino","sequence":"additional","affiliation":[{"name":"Burn Unit, University of Montreal Hospital Centre, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Izadpanah","sequence":"additional","affiliation":[{"name":"Burn Unit, University of Montreal Hospital Centre, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edouard","family":"Coeugniet","sequence":"additional","affiliation":[{"name":"Burn Unit, University of Montreal Hospital Centre, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,7,8]]},"reference":[{"key":"2019101713493103800_CIT0001","volume-title":"Memoirs of military surgery","author":"Larrey","year":"1814","edition":"1"},{"key":"2019101713493103800_CIT0002","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1093\/bmb\/ldw001","article-title":"Freezing and non-freezing cold weather injuries: a systematic review","volume":"117","author":"Heil","year":"2016","journal-title":"Br Med Bull"},{"key":"2019101713493103800_CIT0003","doi-asserted-by":"crossref","first-page":"1930","DOI":"10.1056\/NEJMra1114208","article-title":"Accidental hypothermia","volume":"367","author":"Brown","year":"2012","journal-title":"N Engl J Med"},{"key":"2019101713493103800_CIT0004","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1097\/00005373-200001000-00036","article-title":"Frostbite: pathogenesis and treatment","volume":"48","author":"Murphy","year":"2000","journal-title":"J Trauma"},{"key":"2019101713493103800_CIT0005","doi-asserted-by":"crossref","first-page":"43","DOI":"10.3928\/0147-7447-19970101-09","article-title":"Is urban frostbite a psychiatric disorder?","volume":"20","author":"Pinzur","year":"1997","journal-title":"Orthopedics"},{"key":"2019101713493103800_CIT0006","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1097\/00006534-199309001-00012","article-title":"Frostbite in the prairies: a 12-year review","volume":"92","author":"Valnicek","year":"1993","journal-title":"Plast Reconstr Surg"},{"key":"2019101713493103800_CIT0007","article-title":"Frostbite in the Norwegian Armed Forces","volume":"138","author":"Norheim","year":"2018","journal-title":"Tidsskr Nor Laegeforen"},{"key":"2019101713493103800_CIT0008","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1016\/j.burns.2017.01.013","article-title":"The use of intravenous tPA for the treatment of severe frostbite","volume":"43","author":"Jones","year":"2017","journal-title":"Burns"},{"key":"2019101713493103800_CIT0009","doi-asserted-by":"crossref","first-page":"S43","DOI":"10.1016\/j.wem.2014.09.001","article-title":"Wilderness Medical Society practice guidelines for the prevention and treatment of frostbite: 2014 update","volume":"25","author":"McIntosh","year":"2014","journal-title":"Wilderness Environ Med"},{"key":"2019101713493103800_CIT0010","first-page":"900","article-title":"Studies in experimental frostbite: the effect of heparin in preventing gangrene","volume":"22","author":"Schumaker","year":"1947","journal-title":"Surgery"},{"key":"2019101713493103800_CIT0011","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/2046-7648-3-7","article-title":"Frostbite: a practical approach to hospital management","volume":"3","author":"Handford","year":"2014","journal-title":"Extrem Physiol Med"},{"key":"2019101713493103800_CIT0012","first-page":"215","article-title":"Deep frostbite treated with hyperbaric oxygen and thrombolytic therapies","volume":"27","author":"Higdon","year":"2015","journal-title":"Wounds"},{"key":"2019101713493103800_CIT0013","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1016\/j.jvir.2016.04.027","article-title":"Catheter-directed intraarterial thrombolysis as part of a multidisciplinary management protocol of frostbite injury","volume":"27","author":"Tavri","year":"2016","journal-title":"J Vasc Interv Radiol"},{"key":"2019101713493103800_CIT0014","doi-asserted-by":"crossref","first-page":"e323","DOI":"10.1097\/BCR.0000000000000245","article-title":"Use of intra-arterial thrombolytic therapy for acute treatment of frostbite in 62 patients with review of thrombolytic therapy in frostbite","volume":"37","author":"Gonzaga","year":"2016","journal-title":"J Burn Care Res"},{"key":"2019101713493103800_CIT0015","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1097\/01.ta.0000195517.50778.2e","article-title":"An open-label study to evaluate the safety and efficacy of tissue plasminogen activator in treatment of severe frostbite","volume":"59","author":"Twomey","year":"2005","journal-title":"J Trauma"},{"key":"2019101713493103800_CIT0016","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1056\/NEJM198810063191407","article-title":"Tissue plasminogen activator","volume":"319","author":"Loscalzo","year":"1988","journal-title":"N Engl J Med"},{"key":"2019101713493103800_CIT0017","first-page":"21","article-title":"The use of anticoagulant therapy in frostbite with special reference to heparin","volume":"60","author":"Lewis","year":"1948","journal-title":"Q Res Rep"},{"key":"2019101713493103800_CIT0018","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1097\/00005373-198009000-00006","article-title":"Early sympathetic blockade for frostbite\u2013is it of value?","volume":"20","author":"Bouwman","year":"1980","journal-title":"J Trauma"},{"key":"2019101713493103800_CIT0019","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1177\/1938640011422596","article-title":"Efficacy of intravenous tissue plasminogen activator in frostbite patients and presentation of a treatment protocol for frostbite patients","volume":"4","author":"Johnson","year":"2011","journal-title":"Foot Ankle Spec"},{"key":"2019101713493103800_CIT0020","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1016\/j.jvir.2010.06.014","article-title":"Quality improvement guidelines for percutaneous transcatheter embolization: Society of Interventional Radiology Standards of Practice Committee","volume":"21","author":"Angle","year":"2010","journal-title":"J Vasc Interv Radiol"},{"key":"2019101713493103800_CIT0021","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.amj.2010.08.006","article-title":"Thrombolytic therapy in the acute management of frostbite injuries","volume":"30","author":"Wagner","year":"2011","journal-title":"Air Med J"},{"key":"2019101713493103800_CIT0022","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S0022-4804(64)80004-4","article-title":"Experimental studies in cold injury. II. The pathogenesis of frostbite","volume":"4","author":"Weatherley-White","year":"1964","journal-title":"J Surg Res"},{"key":"2019101713493103800_CIT0023","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1097\/00006534-196507000-00004","article-title":"Experimental studies in cold injury III: observations on the treatment of frostbite","volume":"36","author":"Weatherly-White","year":"1965","journal-title":"Plast Reconstr Surg"},{"key":"2019101713493103800_CIT0024","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1016\/S0196-0644(87)80758-8","article-title":"Experimental and clinical observations on frostbite","volume":"16","author":"Heggers","year":"1987","journal-title":"Ann Emerg Med"},{"key":"2019101713493103800_CIT0025","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0363-5023(81)80010-X","article-title":"Evaluation of hand frostbite blister fluid as a clue to pathogenesis","volume":"6","author":"Robson","year":"1981","journal-title":"J Hand Surg Am"},{"key":"2019101713493103800_CIT0026","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1001\/jama.1992.03480150014005","article-title":"Early data suggest clot-dissolving drug may help save frostbitten limbs from amputation","volume":"267","author":"Skolnick","year":"1992","journal-title":"JAMA"},{"key":"2019101713493103800_CIT0027","doi-asserted-by":"crossref","first-page":"e62","DOI":"10.1097\/BCR.0000000000000135","article-title":"The emerging role of tissue plasminogen activator in the management of severe frostbite","volume":"36","author":"Ibrahim","year":"2015","journal-title":"J Burn Care Res"},{"key":"2019101713493103800_CIT0028","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1001\/archsurg.142.6.546","article-title":"Reduction of the incidence of amputation in frostbite injury with thrombolytic therapy","volume":"142","author":"Bruen","year":"2007","journal-title":"Arch Surg"},{"key":"2019101713493103800_CIT0029","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1097\/00013452-200303000-00017","article-title":"Frostbite","volume":"20","author":"Ahrenholz","year":"2003","journal-title":"Problems Gen Surg"},{"key":"2019101713493103800_CIT0030","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/0891-5849(91)90015-U","article-title":"Evidence for an early free radical-mediated reperfusion injury in frostbite","volume":"10","author":"Manson","year":"1991","journal-title":"Free Radic Biol Med"},{"key":"2019101713493103800_CIT0031","doi-asserted-by":"crossref","first-page":"e877","DOI":"10.1097\/BCR.0000000000000512","article-title":"The use of thrombolytic therapy in the treatment of frostbite injury","volume":"38","author":"Wexler","year":"2017","journal-title":"J Burn Care Res"},{"key":"2019101713493103800_CIT0032","doi-asserted-by":"crossref","first-page":"415","DOI":"10.2214\/ajr.142.2.415","article-title":"Assessment of tissue viability in frostbite by 99mTc pertechnetate scintigraphy","volume":"142","author":"Salimi","year":"1984","journal-title":"AJR Am J Roentgenol"},{"key":"2019101713493103800_CIT0033","first-page":"162","article-title":"Microangiography to monitor treatment outcomes following severe frostbite injury to the hands","volume":"39","author":"Masters","year":"2018","journal-title":"J Burn Care Res"},{"key":"2019101713493103800_CIT0034","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.3928\/0147-7447-19860901-17","article-title":"Frostbite and bone scanning: the use of 99m-labeled phosphates in demarcating the line of viability in frostbite victims","volume":"9","author":"Ikawa","year":"1986","journal-title":"Orthopedics"},{"key":"2019101713493103800_CIT0035","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1097\/00000637-199703000-00015","article-title":"Magnetic resonance imaging of severe frostbite injuries","volume":"38","author":"Barker","year":"1997","journal-title":"Ann Plast Surg"},{"key":"2019101713493103800_CIT0036","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/0020-1383(74)90008-4","article-title":"The possible value of arteriography supplemented by a vasodilator agent in the early assessment of tissue viability in frostbite","volume":"6","author":"Erikson","year":"1974","journal-title":"Injury"}],"container-title":["Journal of Burn Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jbcr\/advance-article-pdf\/doi\/10.1093\/jbcr\/irz118\/29105213\/irz118.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jbcr\/article-pdf\/40\/6\/907\/30161674\/irz118.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jbcr\/article-pdf\/40\/6\/907\/30161674\/irz118.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T07:55:09Z","timestamp":1663919709000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbcr\/article\/40\/6\/907\/5529869"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,8]]},"references-count":36,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2019,7,8]]},"published-print":{"date-parts":[[2019,10,16]]}},"URL":"https:\/\/doi.org\/10.1093\/jbcr\/irz118","relation":{},"ISSN":["1559-047X","1559-0488"],"issn-type":[{"value":"1559-047X","type":"print"},{"value":"1559-0488","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,11]]},"published":{"date-parts":[[2019,7,8]]}}}