We report a case of a 31-year-old male drug addict with acute ischaemia of the right hand after inadverted intraarterial injection of suspended tablets into brachial artery. He was successfully treated with intraarterial administration of urokinase (250'000 IU as bolus, then continuous infusion of 250'000 IU per 12 hours), papaverin (40 mg i.v. 3 x every 4 hours), systematic heparinisation and with axillary plexus anesthesia (Bupivacain 0.25%, 10 ml/h). Treatment options are discussed reviewing recent publications. Early onset of treatment is mandatory for a good outcome.
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