Gabrielpillai Jennis, Salamat Arash, Schaefer Christian, Kania Alexander, Lunatschek Christian, Eichhorn Klaus Wolfgang, Bootz Friedrich, Send Thorsten
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Bonn, Bonn, Germany.
Medical Clinic II, Cardiology, Pneumology and Angiology, University Hospital Bonn, Bonn, Germany.
Plast Reconstr Surg Glob Open. 2020 Nov 25;8(11):e3216. doi: 10.1097/GOX.0000000000003216. eCollection 2020 Nov.
Thrombosis is a serious complication of a hyaluronic acid-based filler injection. Little is known about the late-onset complications of fillers; therefore, an optimal complication management is necessary. In this case report, we describe a rare complication of thrombosis after a filler injection. A 35-year old woman was admitted to the emergency department, with swelling on her forehead in association with recurrent pain and light flashes in her right eye. Sonographic examination showed a thrombosis of the right frontal vein. The patient reported that a hyaluronic acid filler injection had been administered on the forehead 3 months ago. After several weeks of anticoagulation with heparin and apixaban, the symptoms persisted. The vein with thrombosis was ultimately resected under local anesthesia. Histological findings showed a chronic inflammatory reaction of the tissue to hyaluronic acid. Vascular complications may appear as late-onset complications even several months after the filler injection. Subcutaneous application of low molecular weight heparins is the therapy of first choice. If this treatment is not effective, resection of the thrombosis may be performed.
血栓形成是基于透明质酸的填充剂注射的严重并发症。关于填充剂的迟发性并发症知之甚少；因此，需要最佳的并发症管理。在本病例报告中，我们描述了填充剂注射后罕见的血栓形成并发症。一名35岁女性因前额肿胀、右眼反复疼痛和闪光而入住急诊科。超声检查显示右额静脉血栓形成。患者报告3个月前在前额进行了透明质酸填充剂注射。在使用肝素和阿哌沙班抗凝数周后，症状持续存在。最终在局部麻醉下切除了有血栓形成的静脉。组织学检查结果显示组织对透明质酸有慢性炎症反应。血管并发症甚至可能在填充剂注射数月后作为迟发性并发症出现。皮下应用低分子量肝素是首选治疗方法。如果这种治疗无效，可以进行血栓切除术。
