Clinical features associated with HFUS-defined vascular occlusion after hyaluronic acid facial injections: a...

Hyaluronic acid (HA) filler injections are widely used in aesthetic treatments but can cause vascular occlusion. Early diagnosis is often delayed due to reliance on clinical experience. High-frequency ultrasound (HFUS) offers a noninvasive diagnostic method. The study aims to explore the association between clinical warning signs and HFUS-defined vascular occlusion after HA filler injections. This retrospective study analyzed 57 patients with suspected vascular occlusion after HA filler injections. HFUS and a clinical scoring system covering seven symptom categories were used for early evaluation. Occlusion and non-occlusion groups were compared using HFUS and clinical scores. Among 57 clinically suspected cases, 42 (73.7%) were classified as HFUS-defined vascular occlusion and 15 (26.3%) were classified as non-occlusion. In multivariable analysis, skin color change (OR 30.390, 95% CI: 2.482-372.039; p = .008) and delayed capillary refill time (OR 185.936, 95% CI: 2.638- 13,095.200; p = .016) were associated factors of vascular occlusion. A two-variable model incorporating there two features yielded an AUC of 0.944 (95% CI: 0.891-0.998). Skin color change and delayed capillary refill time were associated with HFUS-defined vascular occlusion in this exploratory cohort. These findings may help inform clinical assessment but require prospective validation in independent populations.