Preterm infants admitted to the Neonatal Intensive Care Unit (NICU) often receive either umbilical- or peripheral arterial lines, for frequent blood sampling and monitoring arterial blood pressure. However, arterial lines can lead to severe complications [1] such as tissue ischemia and as a result necrosis of extremities. The consequences of necrotic lesions can be severe and result in thromboembolic events, occurring days or weeks after catheterization.[2] Although no standard approach exists, treatment with topical Nitroglycerin has been described in case reports. ©2013 The Author(s)/Acta Paediatrica ©2013 Foundation Acta Paediatrica.