Related Experiment Video

Updated: Sep 12, 2025

Occlusion of the Great and Small Saphenous Vein Using Copolymeric Glue Based on N-Butyl Cyanoacrylate and Methacryloxy Sulfolane
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Occlusion of the Great and Small Saphenous Vein Using Copolymeric Glue Based on N-Butyl Cyanoacrylate and Methacryloxy Sulfolane

Published on: December 9, 2022

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Guide for Managing Vascular Occlusion Caused by Fillers with Exclusive Cutaneous Involvement: A Review of Diagnosis,

Javier Madero-Pérez1,2, Marta Gil-Martinez3, Cristina Muñoz-Gonzalez4

  • 1Department of Medicine, Universitat Jaume I, Castellón, Spain.

Aesthetic Plastic Surgery
|August 7, 2025
PubMed

Insights

Prompt management of vascular occlusion from hyaluronic acid (HA) fillers is vital. Early intervention within 4-6 hours significantly improves outcomes, with high-dose hyaluronidase being the primary treatment.

Area of Science:

  • Aesthetic Medicine
  • Dermatology
  • Plastic Surgery

Background:

  • Vascular occlusion from hyaluronic acid (HA) fillers poses a risk of permanent tissue damage.
  • Prompt management is crucial for favorable clinical outcomes, excluding ocular complications.
  • Current protocols and modern treatment strategies require evaluation.

Purpose of the Study:

  • To review key factors influencing clinical outcomes of HA filler-induced vascular occlusion.
  • To evaluate current protocols and modern treatment strategies for managing these complications.
  • To develop an action guide for managing vascular occlusion, focusing on technical and pharmacological aspects.

Main Methods:

  • Systematic literature review of PubMed-identified articles (96 relevant articles).
  • Prioritization of publications with significant clinical impact and expert guidelines.
  • Exclusion of older studies to align with modern angiosome concepts and interventional radiology advancements.

Main Results:

  • Pain and skin color changes are primary signs of vascular occlusion.
  • Immediate intervention within 4-6 hours improves prognosis; early ischemia is reversible in up to 80% of cases.
  • High-dose hyaluronidase (HYAL) is the primary treatment; ultrasound guidance reduces dosage. Adjunctive therapies include antiplatelets, corticosteroids, vasodilators, and hyperbaric oxygen therapy.

Conclusions:

  • Accurate diagnosis and prompt intervention based on current angiosome concepts are crucial.
  • Standardized guidelines are needed to enhance patient safety and treatment efficacy in aesthetic medicine.
  • Advanced techniques and protocols improve management of vascular occlusions.
Abstract

Keywords:
Dermal fillersHyaluronidaseIschemia managementVascular occlusion

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