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An Anatomical Analysis of the Supratrochlear Artery: Considerations in Facial Filler Injections and Preventing Vision Loss.

Publication ,  Journal Article
Khan, TT; Colon-Acevedo, B; Mettu, P; DeLorenzi, C; Woodward, JA
Published in: Aesthet Surg J
February 2017

BACKGROUND: Embolia cutis medicamentosa (ECM) is a rare phenomenon attributed to intra-arterial drug injection. Glabellar filler injections can result in potentially devastating visual loss from inadvertent retrograde arteriolar embolization due to the extensive vasculature within the upper face. The minimum amount of filler necessary to potentiate this complication has not yet been reported. OBJECTIVES: We aim to determine the volume of filler necessary to occupy the supratrochlear artery from the glabella to the bifurcation of the ophthalmic and central retinal arteries. We specifically examine the volume of the supratrochlear artery from the glabella to orbital apex. METHODS: The study was approved by Duke University Institutional Review Board and involved surgical dissection of six fresh tissue cadaver heads (12 hemifaces). The arterial system in each cadaver head was injected with latex for visualization. The supratrochlear arteries were isolated anteriorly from the glabella to the orbital apex posteriorly. Intra-orbital vessel radius and length were measured. The vessel volume was calculated by water displacement of the intra-arterial latex. RESULTS: The vessel volumes ranged from 0.04 to 0.12 mL. The average vessel volume was calculated as 0.085 mL, the average length as 51.75 mm, and the average radius as 0.72 mm. CONCLUSIONS: Vascular occlusion from filler injections can lead to devastating visual consequences due to inadvertent retrograde intra-arterial embolization. Our findings indicate that the average entire volume of the supratrochlear artery from the glabella to the orbital apex is 0.085 mL. Injectors should be aware that a bolus of this critical volume may lead to a significant adverse outcome.

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Published In

Aesthet Surg J

DOI

EISSN

1527-330X

Publication Date

February 2017

Volume

37

Issue

2

Start / End Page

203 / 208

Location

England

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Risk Factors
  • Retinal Artery
  • Ophthalmic Artery
  • North Carolina
  • Nicolau Syndrome
  • Male
  • Injections
  • Humans
 

Citation

APA
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ICMJE
MLA
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Khan, T. T., Colon-Acevedo, B., Mettu, P., DeLorenzi, C., & Woodward, J. A. (2017). An Anatomical Analysis of the Supratrochlear Artery: Considerations in Facial Filler Injections and Preventing Vision Loss. Aesthet Surg J, 37(2), 203–208. https://doi.org/10.1093/asj/sjw132
Khan, Tanya T., Betsy Colon-Acevedo, Pradeep Mettu, Claudio DeLorenzi, and Julie A. Woodward. “An Anatomical Analysis of the Supratrochlear Artery: Considerations in Facial Filler Injections and Preventing Vision Loss.Aesthet Surg J 37, no. 2 (February 2017): 203–8. https://doi.org/10.1093/asj/sjw132.
Khan TT, Colon-Acevedo B, Mettu P, DeLorenzi C, Woodward JA. An Anatomical Analysis of the Supratrochlear Artery: Considerations in Facial Filler Injections and Preventing Vision Loss. Aesthet Surg J. 2017 Feb;37(2):203–8.
Khan, Tanya T., et al. “An Anatomical Analysis of the Supratrochlear Artery: Considerations in Facial Filler Injections and Preventing Vision Loss.Aesthet Surg J, vol. 37, no. 2, Feb. 2017, pp. 203–08. Pubmed, doi:10.1093/asj/sjw132.
Khan TT, Colon-Acevedo B, Mettu P, DeLorenzi C, Woodward JA. An Anatomical Analysis of the Supratrochlear Artery: Considerations in Facial Filler Injections and Preventing Vision Loss. Aesthet Surg J. 2017 Feb;37(2):203–208.
Journal cover image

Published In

Aesthet Surg J

DOI

EISSN

1527-330X

Publication Date

February 2017

Volume

37

Issue

2

Start / End Page

203 / 208

Location

England

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Risk Factors
  • Retinal Artery
  • Ophthalmic Artery
  • North Carolina
  • Nicolau Syndrome
  • Male
  • Injections
  • Humans