Intravenous Hyaluronidase with Urokinase as Treatment for Arterial Hyaluronic Acid Embolism

Abstract

Combined use of hyaluronidase and urokinase can help increase the flap survival rate when administered intravenously in intraarterial hyaluronic acid occlusion cases. Both red thrombus and hyaluronic acid emboli must be dissolved for flap reperfusion. This method shows a promising effect for future application.

The treatment of hyaluronic acid aesthetic interventional induced visual loss (AIIVL): A consensus on practical guidance

“…We have looked at the clinical condition of Central Retinal Arterial Occlusion and provided guidance that may be of practical use to the practitioner, specialist, and continuing support of the patient should this devastating adverse event occur. There continues to be discussion on the role of retrobulbar infiltration of hyaluronidase; the risks of this technique and lack of efficacy in recent reports when balanced with the guidance for CRAO have led us to provide guidance that has some clinical basis including techniques that are readily available to the practitioner and specialist.…”

“…been shown to be very effective in an animal model. 17 This has been reported to be effective in one case report. 18 The presumed mechanism is that proximal to the emboli, there is vascular stasis, which results in a thrombus.…”

“…Recent use of IV Urokinase & hyaluronidase in high doses has been shown to be very effective in an animal model . This has been reported to be effective in one case report .…”

“…There continues to be discussion on the role of retrobulbar infiltration of hyaluronidase; the risks of this technique and lack of efficacy in recent reports 17 when balanced with the guidance for CRAO have led us to provide guidance that has some clinical basis including techniques that are readily available to the practitioner and specialist.…”

The study of histological changes of the arterial vascular structure after hyaluronidase exposure

“…However, evaluation of vascular endothelial structure change or damage was not conducted in the study . In 2016, intravenous hyaluronidase injection in combination with urokinase for ophthalmic artery occlusion by HA filler in rabbits was able to resolve retinal artery hyaluronic acid embolism if given within 30 minutes . The doses injected were 5000 IU/kg bovine hyaluronidase and 50 000 IU/kg urokinase.…”