Superselective Ophthalmic Artery Thrombolytic Therapy for Hyaluronic Acid Embolization: A Case Report

Wu, Qian; Fu, Qiang; Xu, Xiao; Zheng, Can; Zhang, Jie; Chen, Minliang

doi:10.2147/ccid.s367481

Cited by 5 publications

(3 citation statements)

References 16 publications

(17 reference statements)

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“…31 The treatment of autologous fat-associated embolism is hampered by the lack of effective thrombolytics, 32 whereas the thrombolytic treatment of HA-associated embolism lacks supporting evidence. 33 Under such circumstances, Tansatit et al 34 reported improving the technique for arterial bypass surgery, and Wang et al 35 successfully used intraarterial mechanical recanalization, with both of these approaches showing significant potential. Recently, hyperbaric oxygen therapy has been found to significantly improve the oxygen supply at the embolic site, thereby inhibiting tissue necrosis.…”

Section: Discussionmentioning

confidence: 99%

Clinical Manifestations and Prognosis of Embolism Caused by Filler Injection in Different Facial Regions

Zhuang,

Zheng,

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Embolism is a serious complication after facial filling, with a usually poor prognosis of the symptoms after embolism. The authors systematically reviewed reported cases of facial vascular embolism, explored the relationship between the location and material used for facial filling and occurrence of vascular embolism, and assessed the prognosis of complications after vascular embolism. Methods: This study provides a systematic review of published cases of vascular embolism after facial filling. A summary of the filling materials and filling sites for each case, the adverse reactions and embolized blood vessels, a recording of the time when each patient experienced adverse reactions and started treatment, and a presentation of their prognosis are provided. Results: The frontal, eyebrow, and nose are common filling sites causing facial embolism. The main clinical manifestations after embolism were visual impairment, skin necrosis, and ptosis. The prognosis of visual impairment after embolization was poor, whereas skin necrosis and ptosis generally improved after treatment. Conclusions: This article aimed to review the clinical manifestations, therapies, and prognosis of embolism after facial filling. A better understanding of these complications can help clinicians to detect the occurrence of complications as early as possible and give patients timely treatment.

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Section: Discussionmentioning

confidence: 99%

Clinical Manifestations and Prognosis of Embolism Caused by Filler Injection in Different Facial Regions

Zhuang,

Zheng,

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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“…Currently available treatment options include: high-dose hyaluronidase injections (both periocular and retrobulbar), intra-arterial thrombolysis in combination with intra-arterial hyaluronidase injection, traditional systemic thrombolytic therapy, eye massage, anterior chamber paracentesis, and hyperbaric oxygen therapy [3,4]. Of these, intraarterial thrombolysis in combination with intra-arterial injection of hyaluronidase seems the most effective, but this method requires appropriate specialists and equipment [5]. Regarding local hyaluronidase injection, that is considered as a first-choice option to dissolve the filler, a recently published consensus guidance for the treatment of hyaluronic acid aesthetic interventional induced visual loss (AIIVL) suggests that retrobulbar hyaluronidase injection is not effective in case of complete obstruction of the central retinal artery and is associated with additional risks to the patients in case being performed by an inexperienced personal [6].…”

Section: Discussionmentioning

confidence: 99%

Reversible Vision Loss Following Nonsurgical Filler Rhinoplasty

Sheptulin

Grusha

2022

Russ Open Med J

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The increase in the frequency and popularity of aesthetic filler injections is accompanied by a high risk of complications, including ophthalmological sequalae. Of these, loss of vision is considered the most dangerous and, in most cases, irreversible. We present a case report of a patient who experienced acute vision loss due to suspected partial occlusion of the ophthalmic artery following nonsurgical rhinoplasty with hyaluronic acid filler injection. It differs from others in that treatment in the form of a combination of multiple subcutaneous hyaluronidase injections into the periocular region, a single retrobulbar injection of hyaluronidase, and hyperbaric oxygen therapy led to a significant recovery of ophthalmic symptoms with only residual visual field defects remaining.

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“…Soft tissue filler injections are among the most popular nonsurgical facial rejuvenation methods worldwide; more than 5.5 million filler injections were used in 2014, and more than $11 billion in revenue was generated annually 1 , 2 . Among these fillers, hyaluronic acid (HA) is a frequently used injectable filler, and more than 800,000 Americans receive HA injections each year due to its durability, biocompatibility, reabsorption, and cost effectiveness 3 . Despite the high safety profile of HA, complications can occur, especially when HA is injected by inexperienced doctors or via substandard "syringes" 4 .…”

Section: Introductionmentioning

confidence: 99%

Disastrous cerebral and ocular vascular complications after cosmetic facial filler injections: a retrospective case series study

Zhao,

Chen,

et al. 2024

Sci Rep

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Soft tissue filler injections are among the most popular facial rejuvenation methods. Cerebral infarction and ophthalmic artery occlusion are rare and catastrophic complications, especially when facial cosmetic fillers are injected by inexperienced doctors. Radiologists and plastic surgeons need to increase their awareness of the complications associated with fillers, which allows early diagnosis and intervention to improve patient prognosis. Regarding the mechanism by which vascular occlusion occurs after facial filler injections, a retrograde embolic mechanism is currently the predominant theory. Numerous case reports have been presented regarding complications associated with injections of facial aesthetics. However, the small sample sizes of these studies did not allow for an adequate assessment of the clinical and imaging manifestations based on the location of the occlusion and the type of filler, and detailed elaboration of multiple cerebral infarctions is also lacking. Therefore, this study aimed to investigate the clinical and radiological features of severe cerebral and ocular complications caused by cosmetic facial filler injections. In addition, we discuss the pathogenesis, treatment, and prognosis of these patients. The clinical, computed tomography (CT), magnetic resonance imaging (MRI), and digital subtraction angiography (DSA) findings were described and analysed. Radiological examinations are crucial for demonstrating severe complications, and brain MRI is especially strongly suggested for patients with cosmetic filler-induced vision loss to identify asymptomatic cerebral infarctions. Extreme caution and care should be taken during facial injections by plastic surgeons.

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Superselective Ophthalmic Artery Thrombolytic Therapy for Hyaluronic Acid Embolization: A Case Report

Cited by 5 publications

References 16 publications

Clinical Manifestations and Prognosis of Embolism Caused by Filler Injection in Different Facial Regions

Clinical Manifestations and Prognosis of Embolism Caused by Filler Injection in Different Facial Regions

Reversible Vision Loss Following Nonsurgical Filler Rhinoplasty

Disastrous cerebral and ocular vascular complications after cosmetic facial filler injections: a retrospective case series study

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