BACKGROUND: Hyaluronidase (HYAL) has been recommended in the emergency treatment of ischemia caused by accidental intra-arterial injection of hyaluronic acid (HA) dermal fillers. To date, there have been no published studies showing that HYAL can pass through intact arterial wall to hydrolyze HA emboli. OBJECTIVE: The goal of this study was to study whether or not HYAL could cross intact human facial arterial wall to hydrolyze HA filler. MATERIALS AND METHODS: Short tied-off segments of fresh human cadaver-sourced facial artery specimens, overfilled with a monophasic dermal filler (dermal filler "sausages"), were immersed in either HYAL or normal saline as controls. At 4 and 24 hours, the vessels were removed from the preparations, and one end of each vessel was cut open. RESULTS: Only the HYAL-immersed specimens showed degradation of filler gel. CONCLUSION: In conclusion, cross-linked HA is susceptible to hydrolysis by HYAL when contained within the intact facial artery in a cadaver model, indicating that direct intra-arterial injection of HYAL is likely not necessary to help restore the circulation of ischemic tissues. This bench study provides support for the current recommended treatment of accidental intra-arterial injection with HYAL injection diffusely into ischemic tissues.
BACKGROUND: Hyaluronidase (HYAL) has been recommended in the emergency treatment of ischemia caused by accidental intra-arterial injection of hyaluronic acid (HA) dermal fillers. To date, there have been no published studies showing that HYAL can pass through intact arterial wall to hydrolyze HA emboli. OBJECTIVE: The goal of this study was to study whether or not HYAL could cross intact human facial arterial wall to hydrolyze HA filler. MATERIALS AND METHODS: Short tied-off segments of fresh human cadaver-sourced facial artery specimens, overfilled with a monophasic dermal filler (dermal filler "sausages"), were immersed in either HYAL or normal saline as controls. At 4 and 24 hours, the vessels were removed from the preparations, and one end of each vessel was cut open. RESULTS: Only the HYAL-immersed specimens showed degradation of filler gel. CONCLUSION: In conclusion, cross-linked HA is susceptible to hydrolysis by HYAL when contained within the intact facial artery in a cadaver model, indicating that direct intra-arterial injection of HYAL is likely not necessary to help restore the circulation of ischemic tissues. This bench study provides support for the current recommended treatment of accidental intra-arterial injection with HYAL injection diffusely into ischemic tissues.
Authors: Marco Antonio Munia; Christine Guarnieri Munia; Meire Brasil Parada; Jose Ben-Hurferraz Parente; Nelson Wolosker Journal: J Clin Aesthet Dermatol Date: 2022-02
Authors: Massimo Signorini; Steven Liew; Hema Sundaram; Koenraad L De Boulle; Greg J Goodman; Gary Monheit; Yan Wu; Ada R Trindade de Almeida; Arthur Swift; André Vieira Braz Journal: Plast Reconstr Surg Date: 2016-06 Impact factor: 4.730
Authors: Jani van Loghem; David Funt; Tatjana Pavicic; Kate Goldie; Yana Yutskovskaya; Sabrina Fabi; Pieter Siebenga; Job Thuis; Joseph Hkeik; Jonathan Kadouch; Welf Prager; Nabila Azib; Gabriela Casabona; Steve Dayan; Shino Bay Aguilera; Philippe Snozzi; Peerooz Saeed Journal: J Cosmet Dermatol Date: 2020-03-17 Impact factor: 2.696