The emerging role of tissue plasminogen activator in the management of severe frostbite

J Burn Care Res. 2015 Mar-Apr;36(2):e62-6. doi: 10.1097/BCR.0000000000000135.


This article presents a small case series demonstrating clinical success with thrombolytic agents for severe frostbite injury to the lower extremities. The authors report three patients with severe frostbite injuries to their distal lower extremities who were managed with urgent interventional radiology and intra-arterial tissue plasminogen activator infusion according to a prespecified protocol. Limbs and digits were successfully salvaged and patients returned to normal activity within 2 weeks. Although further studies are needed, results of this study support a new approach in the management of frostbite: from conservative management and observation to urgent interventional radiology and possible tissue plasminogen activator infusion. A protocol for the management of such injuries is presented.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Fibrinolytic Agents / administration & dosage*
  • Fingers / blood supply
  • Fingers / diagnostic imaging*
  • Frostbite / diagnostic imaging
  • Frostbite / drug therapy*
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Radionuclide Imaging
  • Tissue Plasminogen Activator / administration & dosage*
  • Toes / blood supply
  • Toes / diagnostic imaging*
  • Treatment Outcome


  • Fibrinolytic Agents
  • Tissue Plasminogen Activator