title: Comparison of Intra-arterial and Subcutaneous Testicular Hyaluronidase Injection Treatments and the Vascular Complications of Hyaluronic Acid Filler.
abstract: BACKGROUND
  Hyaluronidase is a key preventative treatment against vascular complications of hyaluronic acid (HA) filler injection, but the degradation profile of HA to hyaluronidase is limited, and the comparison between intra-arterial and subcutaneous injections of hyaluronidase has not been studied.
  
  
  OBJECTIVE
  To evaluate HA degradation to hyaluronidase and compare different treatments between intra-arterial and subcutaneous testicular hyaluronidase injections.
  
  
  METHODS
  The authors observed HA degradation to hyaluronidase in vitro via microscopic examination and particle analysis. Rabbit ears were used for the in vivo study. There were 2 control groups receiving ligation or HA-induced embolism in the arteries, respectively, and 2 intervention groups receiving hyaluronidase treatments in different regions. The laser Doppler blood perfusion monitoring measurements were made at defined time points, and biopsies were taken on Day 2.
  
  
  RESULTS
  Nearly, all of the HAs degraded in vitro at the 1-hour time point. Subcutaneous hyaluronidase treatment showed better recovery of blood perfusion. Histology showed severe inflammation in the embolism group and mild inflammation in the intervention groups.
  
  
  CONCLUSIONS
  A complete enzymatic degradation of HA filler to hyaluronidase needs a certain time, and subcutaneous hyaluronidase treatment may be the better option.
authors.affiliation: *State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, P.R.China; †Department of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, P.R.China; ‡National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, P.R. China.
authors.forename: Muyao
authors.initials: M
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Weidong
authors.initials: W
authors.lastname: Tian
authors.forename: Hang
authors.initials: H
authors.lastname: Wang
mesh_terms: D000818:Animals; D000067548:Dermal Fillers / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics*; D004617:Embolism / Q000139:chemically induced / Q000503:physiopathology / Q000517:prevention & control; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics*; D006821:Hyaluronoglucosaminidase / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D007269:Injections, Intra-Arterial; D007279:Injections, Subcutaneous; D008026:Ligation; D008297:Male; D011817:Rabbits; D012039:Regional Blood Flow / Q000187:drug effects; D013737:Testis
chemical_list: D000067548:Dermal Fillers; D006820:Hyaluronic Acid; D006821:Hyaluronoglucosaminidase