Surgeon's Guide to Facial Soft Tissue Filler Injections: Relevant Anatomy and Safety Considerations.

The purpose of this study is to provide a review of the relevant facial anatomy related to soft tissue filler injections. Facial fillers are used daily in our clinical practice. Although their use is safe and predictable, adverse events do occur. Some of these dire events include vascular complications leading to blindness, ischemia, and even stroke. Proper knowledge and understanding of the anatomic landmarks can minimize the risk of these vascular events. In addition, early recognition and treatment are necessary to prevent permanent complications.

An Overview of Vascular Adverse Events Associated With Facial Soft Tissue Fillers: Recognition, Prevention, and Treatment.

Minimally invasive facial cosmetic surgery procedures have seen an exponential increase in numbers over the past decade. The most commonly performed procedures are neuromodulator and soft tissue filler procedures. Although soft tissue fillers have a high safety and predictability profile, these procedures recently have been associated with serious and dire adverse events. This article will discuss some of the vascular complications associated with facial soft tissue fillers. Management and prevention of these adverse events also will be discussed.

Abdominal aortic aneurysm repair complicated by infection with Clostridium septicum.

Aortic stent-graft infection after endovascular abdominal aortic aneurysm (AAA) repair is an uncommon, but very serious complication with potentially devastating consequences.(1) Traditional open techniques of repair of AAA demonstrate an infection rate of 0.5-3%. The exact rate of infection with endovascular repair is unknown, but literature review demonstrates an overall incidence of 0.43-1.17% retrospectively.(2,3) Etiology of endovascular graft infections typically results from flora derived from the skin or gastrointestinal tract.(4)Clostridium septicum is a naturally occurring anaerobic bacterium native to the gastrointestinal tract. It is typically associated with spontaneous nontraumatic gas gangrene owing to bacteremia from the gastrointestinal tract with an incidence rate of 0.07%.(5) To our knowledge, this is the first reported case of endovascular AAA graft infection owing to Clostridium septicum species.

Acute mesenteric and aortic thrombosis associated with antithrombin deficiency: a rare occurrence.

Antithrombin is a potent inhibitor of the coagulation cascade exerting its primary effects on activated factors X, IX and II. It is the mechanism by which heparin and low-molecular weight heparin cause anti-coagulation. Deficiency of antithrombin presents as a hypercoagulable state, and may result in unexplained deep venous thrombosis, arterial thrombosis and systemic embolization.

Interventional Radiology and Bleeding Disorders: What the Oral and Maxillofacial Surgeon Needs to Know.

Endovascular techniques are essential for controlling acute head and neck bleeding that cannot be controlled by local or systemic measures. Detailed knowledge of the head and neck vascular anatomy, advances in catheterization techniques, and the availability of new embolic materials have improved the safety, efficacy, and predictability of these procedures. To improve patient safety, the oral and maxillofacial surgeon must be familiar with these techniques.

Endovascular repair of transplant nephrectomy external iliac artery pseudoaneurysm.

The formation of a pseudoaneurysm at the site of transplant nephrectomy is a rare complication, having been reported only six previous times in the literature. Possible causes of this occurrence include infection or rejection of the anastomotic remnant. Diagnosis of the pseudoaneurysm with radiological imaging is necessary. The first successful repair of a noninfected pseudoaneurysm of a transplant nephrectomy patient is described using an endovascular graft.

Staged arterial embolization and surgical resection of a giant splenic artery aneurysm.

Splenic artery aneurysms (SAAs) are increasingly being diagnosed as incidental findings. Management modalities include operative treatment, percutaneous embolization, laparascopic ligation, and observation. Giant SAAs larger than 8 cm are a rare entity. We report the case of a 78-year-old woman with an 11 cm SAA who underwent successful percutaneous embolization, followed by surgical excision. We discuss the management of this patient and provide a review of the relevant literature. The approach to SAA should remain individualized.