Sito Giuseppe, Manzoni Veronica, Sommariva Raffaella
Prof. Sito is with the Prof. Professor Giuseppe Sito Clinic in Turin, Italy.
Dr. Manzoni is with the Istituto Auxologico Italiano in Milan, Italy.
J Clin Aesthet Dermatol. 2019 Jun;12(6):E65-E72. Epub 2019 Jun 1.
Vascular occlusion during the injection of facial fillers is uncommon, but can result in serious adverse events, including necrosis, blindness, and stroke. We explored factors that influence the frequency and severity of vascular complications during filler injections. This was a meta-analysis that included case reports and case series published during the years 2004 to 2016 describing patients who experienced any type of vascular complication after an aesthetic procedure. In addition to the descriptive analysis of the variables retrieved, a logistic regression for predicting the outcome of the vascular event was performed. The analysis included 93 cases described in 30 articles. Blindness was the main consequence of the vascular complications (n=57; 61%). The reported outcome was partial or total recovery in 24 cases (28%) and no improvement in 61 cases (72%). Hyaluronic acid (HA) and autologous fat were the two fillers most frequently involved in vascular occlusions, with autologous fat showing a stronger trend toward no improvement than HA. Involvement of the ophthalmic and retinal arteries was most frequently associated with no improvement. Injury to ophthalmic and retinal arteries during the injection of facial fillers can result in irreversible serious adverse events. Physicians performing facial filler injections should have a proficient knowledge of anatomy.
面部填充剂注射过程中的血管阻塞并不常见，但可能导致严重的不良事件，包括坏死、失明和中风。我们探讨了影响填充剂注射过程中血管并发症发生频率和严重程度的因素。这是一项荟萃分析，纳入了2004年至2016年期间发表的病例报告和病例系列，描述了美容手术后出现任何类型血管并发症的患者。除了对检索到的变量进行描述性分析外，还进行了逻辑回归以预测血管事件的结果。该分析包括30篇文章中描述的93例病例。失明是血管并发症的主要后果（n = 57；61%）。报告的结果是24例（28%）部分或完全恢复，61例（72%）无改善。透明质酸（HA）和自体脂肪是最常与血管阻塞相关的两种填充剂，自体脂肪比HA显示出更强的无改善趋势。眼动脉和视网膜动脉受累最常与无改善相关。面部填充剂注射过程中眼动脉和视网膜动脉损伤可导致不可逆的严重不良事件。进行面部填充剂注射的医生应具备熟练的解剖学知识。
