Intraarterial Thrombolytic Treatment for Visual Deficits Caused by Hyaluronic Acid Filler: Efficacy, Safety, and Prognostic Factors

Author:

Wang Yingliang12,Li Qian3,Ye Yongsheng4,Zhang Jie3,Shen Haiyang3,Zhou Yu3,Zhou Chen12,Yu Youtao3,Xiong Bin124

Affiliation:

1. Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

2. Hubei Key Laboratory of Molecular Imaging

3. Department of Interventional Radiology, The Fourth Medical Center of PLA General Hospital

4. Department of Interventional Radiology, The First Affiliated Hospital of Guangzhou Medical University.

Abstract

Background: The benefits of intraarterial thrombolytic treatment (IATT) in reversing hyaluronic acid (HA)–related visual deficits remain unclear. This study aimed to report a 5-year experience in the treatment of visual deficits resulting from HA embolization by IATT in a tertiary medical center. Methods: From December of 2015 to June of 2021, the medical records of consecutive patients with HA-related visual deficits who underwent IATT were reviewed retrospectively. The demographics, clinical features, imaging data, treatment details, and follow-up results of the patients were analyzed. Results: A total of 72 consecutive patients were analyzed, including five men (6.9%) men and 67 women (3.1%), aged 29.3 ± 7.6 years (range, 17 to 50 years). Thirty-two patients (44.4%) showed preserved visual acuity, and 40 (55.6%) exhibited no light perception on admission. Ocular motility disorders were detected in 63 patients (87.5%), ptosis was detected in 61 patients (84.7%), and facial skin changes were detected in 54 patients (75%). The technical success rate of IATT was 100%, with successful recanalization of the occlusive artery. No procedure-related complications were detected, and all skin injuries, ptosis, and ocular motility disorders were healed. Improved visual acuity was detected in 26 cases (36.1%). In the binary logistic regression model, only preoperative preserved visual acuity was independently associated with a good outcome. Conclusions: IATT for selective patients with HA-related visual deficits is efficient and safe. Preoperative preserved visual acuity was independently associated with a good outcome after IATT. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Surgery

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