背景:威胁皮肤完整性的透明质酸(HA)填充剂诱导的血管栓塞是当务之急。越来越多的证据表明,经皮动脉内注射透明质酸酶是一种有效的治疗技术。然而,直到现在,该技术缺乏统一的协议。
目的:本研究旨在提供经皮动脉内注射透明质酸酶以及辅助措施治疗基于HA的填充剂沉淀的闭塞的结论,并制定逐步治疗方案。
方法:我们搜索了PubMed的同行评审研究,共识声明,案例系列,和病例报告使用各种关键字。
结果:高剂量,脉冲透明质酸酶是治疗HA填充剂引起的栓塞的主要药物,但是经皮动脉内注射透明质酸酶是一种更有效的技术。直到现在,透明质酸酶经皮注射到三个动脉,包括面部动脉,滑车上动脉,和颞浅动脉.此外,应考虑可以优化阻塞清除和/或皮肤屏障修复的辅助措施,例如使用图像指导和CGF。
结论:威胁皮肤完整性的血管闭塞是当务之急,需要准确诊断和有效干预。经皮动脉内透明质酸酶注射以及以逐步方式进行的辅助措施是最佳结果的关键。
方法:本期刊要求作者为每个提交的证据分配一个级别,该级别的证据适用于循证医学排名。这不包括评论文章,书评,和有关基础科学的手稿,动物研究,尸体研究,和实验研究。对于这些循证医学评级的完整描述,请参阅目录或在线作者说明www。springer.com/00266.
BACKGROUND: Hyaluronic acid (HA) filler-induced vascular embolism that threatens skin integrity is an urgent situation. There is increasing evidence that percutaneous intra-arterial hyaluronidase injection is an effective therapeutic technique for it. However, until now, there is a lack of a unifying protocol about the technique.
OBJECTIVE: This study aims to provide a conclusion of percutaneous intra-arterial hyaluronidase injection along with adjunctive measures on the treatment of occlusions precipitated by HA-based filler and develop a stepwise treatment protocol.
METHODS: We searched PubMed for peer-reviewed studies, consensus statements, case series, and case reports using a variety of keywords.
RESULTS: High-dose, pulsed hyaluronidase is the mainstay for the treatment of HA filler-induced embolism, but percutaneous intra-arterial hyaluronidase injection is a more effective technique. Until now, hyaluronidase is injected into three arteries percutaneously, including facial artery, supratrochlear artery, and superficial temporal artery. Furthermore, the adjunctive measures that may optimize clearance of an occlusion and/or skin barrier repair such as the use of image guidance and CGF should be considered.
CONCLUSIONS: Vascular occlusions that threaten skin integrity are an urgent matter which requires accurate diagnosis and effective intervention. Percutaneous intra-arterial hyaluronidase injection along with adjunctive measures performed in a stepwise manner is key to an optimal outcome.
METHODS: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .