An Anatomical Analysis of the Supratrochlear Artery: Considerations in Facial Filler Injections and Preventing Vision Loss
| Autor: | Claudio DeLorenzi, Pradeep Mettu, Julie A. Woodward, Betsy Colon-Acevedo, Tanya T. Khan |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Central retinal artery Retinal Artery Adverse outcomes medicine.medical_treatment Supratrochlear artery Arterial Occlusive Diseases Cosmetic Techniques 030230 surgery Blindness Vascular occlusion Injections Ophthalmic Artery 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Risk Factors Cadaver Dermal Fillers medicine.artery North Carolina medicine Humans Embolization business.industry Dissection General Medicine Anatomy Glabella Treatment Outcome medicine.anatomical_structure Nicolau Syndrome Face Female Surgery medicine.symptom business Critical volume |
| Zdroj: | Aesthetic Surgery Journal. 37:203-208 |
| ISSN: | 1527-330X 1090-820X |
| DOI: | 10.1093/asj/sjw132 |
| Popis: | Background Embolia cutis medicamentosa (ECM) is a rare phenomenon attributed to intra-arterial drug injection. Glabellar filler injections can result in potentially devastating visual loss from inadvertent retrograde arteriolar embolization due to the extensive vasculature within the upper face. The minimum amount of filler necessary to potentiate this complication has not yet been reported. Objectives We aim to determine the volume of filler necessary to occupy the supratrochlear artery from the glabella to the bifurcation of the ophthalmic and central retinal arteries. We specifically examine the volume of the supratrochlear artery from the glabella to orbital apex. Methods The study was approved by Duke University Institutional Review Board and involved surgical dissection of six fresh tissue cadaver heads (12 hemifaces). The arterial system in each cadaver head was injected with latex for visualization. The supratrochlear arteries were isolated anteriorly from the glabella to the orbital apex posteriorly. Intra-orbital vessel radius and length were measured. The vessel volume was calculated by water displacement of the intra-arterial latex. Results The vessel volumes ranged from 0.04 to 0.12 mL. The average vessel volume was calculated as 0.085 mL, the average length as 51.75 mm, and the average radius as 0.72 mm. Conclusions Vascular occlusion from filler injections can lead to devastating visual consequences due to inadvertent retrograde intra-arterial embolization. Our findings indicate that the average entire volume of the supratrochlear artery from the glabella to the orbital apex is 0.085 mL. Injectors should be aware that a bolus of this critical volume may lead to a significant adverse outcome. |
| Databáze: | OpenAIRE |
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