Beautician's nightmare: artery embolization

One of the most formidable complications in aesthetic medicine is arterial embolization, which can lead to ischemia, necrosis and even blindness.

Detailed knowledge of anatomy is required to ensure the prevention of this side effect. However, this is not always enough, due to the presence of individual characteristics of the location of blood vessels in humans. In this regard, doctors resort to an aspiration test.

For information on how effective this method is, and whether it is worth trusting, read on estet-portal.com in this article.

Artery embolization in cosmetology: how to prevent the irreparable

Safety issues in aesthetic medicine are always relevant. Every doctor strives to minimize the risks of complications, and especially those that can lead to irreversible changes.

Intra-arterial injection of gel-like drugs leads to a critical decrease in blood flow in a certain anatomical area, which can cause ischemia and then necrosis.

To limit the risk of embolization, many experts advocate aspiration prior to injection, as blood in the center of the needle during this manipulation will confirm its intravascular location.

Read also: Safely inserting fillers: how to prevent possible complications

Why can't the aspiration test be a safety criterion

There are a huge number of factors that affect the effectiveness of aspiration, the most significant are:

•    drug rheology;

•    needle size (diameter, length);

•    Syringe dimensions;

•    aspiration time;

•    negative pressure generated during aspiration;

•    blood pressure.

The specificity of the aspiration test is high, since the appearance of blood indicates a very high probability that the needle is intravascular. However, the sensitivity of aspiration as a diagnostic test is low because the absence of blood does not preclude the possibility of intravascular placement of the needle tip.

What volume of filler results in arterial embolization

Studies have shown that the average volume of filler that results in embolization of an artery is approximately 0.08 ml, however, vessel occlusion can occur with as little as 0.04 ml. Therefore, the maximum injectable volume should not exceed 0.04 ml per bolus when injected with a needle, given the possibility of this complication.

The effectiveness of aspiration depends on differences in the physiochemical structure and rheological properties of the fillers.

The higher the density of the dermal filler, the greater the likelihood of a false-negative aspiration test.

How to avoid complications after minimally invasive cosmetic procedures

Effective methods to prevent arterial embolization

To achieve optimal results and precise product placement, knowledge of anatomy is the key to success.

In addition, the risk of intra-arterial embolism can be reduced by adhering to

the following recommendations:

•    need to be careful even with negative aspiration test results;

•    for work in hazardous areas, it is better to use the retrograde technique of drug administration;

•    it is best to avoid large bolus injections;

•    avoid high pressure injections;

•    prefer cannulas;

•    in hazardous areas, inject with minimal boluses at low pressure.

While a positive test result (blood in the center of the needle) can be of great importance in clinical practice, clinicians should not rely on the reliability of a negative test result.

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