Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese People's Liberation Army General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100038, China.
Department of Interventional Radiology, The Fourth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.
Aesthetic Plast Surg. 2024 Sep;48(18):3561-3567. doi: 10.1007/s00266-024-04004-2. Epub 2024 May 8.
Arterial embolism is a rare complication caused by hyaluronic acid (HA) injection. However, it is one of the most serious complications. Once it happens, the complication would have a great and long-term impact on patients. Intra-arterial recanalization has been reported for recovering the visual acuity in patients with visual loss caused by hyaluronic acid. There is little report about the benefits of superselective intra-arterial recanalization therapy for skin wounds caused by hyaluronic acid vascular embolization.
Eight patients who had received the superselective intra-arterial recanalization therapy were retrospectively reviewed. Hyaluronidase was injected into the facial artery by superselective intra-arterial recanalization therapy, followed by symptomatic treatment. The facial artery recanalization was successfully performed and no interventional procedure-related adverse events happened.
Arterial embolization accompanies by the interruption or reduction of blood supply, followed by ochrodermia, pain, numbness, swelling, yellowish white secreta and even necrosis on skin wound area. Early detection of skin blood supply disorders and early recovery of blood supply are very critical to treat facial artery embolization caused by HA. After superselective intra-arterial recanalization therapy, the blood supply to facial skin was restored and skin wounds recovered in all patients. Only 1 patient was left with small and superficial scars.
Superselective intra-arterial recanalization therapy is an effective and safe method that can alleviate skin wounds caused by HA vascular embolization.
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动脉栓塞是透明质酸(HA)注射引起的罕见并发症。然而,它是最严重的并发症之一。一旦发生,并发症将对患者造成重大且长期的影响。已有报道称,腔内再通术可恢复因透明质酸引起的视力丧失患者的视力。关于腔内超选择性再通治疗对透明质酸血管栓塞引起的皮肤伤口益处的报道较少。
回顾性分析 8 例行腔内超选择性再通治疗的患者。通过腔内超选择性再通治疗向面动脉内注射透明质酸酶,然后进行对症治疗。成功地进行了面动脉再通,且无介入操作相关不良事件发生。
动脉栓塞伴有供血中断或减少,继而出现皮肤发绀、疼痛、麻木、肿胀、黄白色分泌物,甚至皮肤伤口区域坏死。早期发现皮肤血供障碍,早期恢复血供对治疗透明质酸引起的面动脉栓塞非常重要。行腔内超选择性再通治疗后,所有患者的面部皮肤血供恢复,皮肤伤口愈合。仅 1 例患者遗留小而表浅的瘢痕。
腔内超选择性再通治疗是一种有效且安全的方法,可缓解透明质酸血管栓塞引起的皮肤伤口。
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