Three-Dimensional Computed Tomography Scanning of Temporal Vessels to Assess the Safety of Filler Injections

2021 ◽  
Author(s):  
Chun-Lin Chen ◽  
Li-Yao Cong ◽  
Xiang-Xue Kong ◽  
Wei-Rui Zhao ◽  
Wei-Jin Hong ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coordinate System ◽  
Superficial Temporal Artery ◽  
Vascular Complications ◽  
Temporal Artery ◽  
External Carotid ◽  
3D Images ◽  
Filler Injection ◽  
Computed Tomography Scanning ◽  
Filler Injections

Abstract Background Temple filler injection is one of the most common minimally invasive cosmetic procedures involving the face; however, vascular complications are not uncommon. Objectives This study aimed to investigate the anatomy of the temporal vessels and provide a more accurate protocol for temple filler injection. Methods Computed tomography (CT) scans of 56 cadaveric heads injected with lead oxide were obtained. We then used Mimics software to construct 3-dimensional (3D) images of the temporal vessels described by a coordinate system based on the bilateral tragus and right lateral canthus. Results In the XOY plane, the superficial temporal artery (STA), middle temporal artery (MTA), zygomatico-orbital artery (ZOA), posterior branch of the deep temporal artery (PDTA), and lateral margin of the orbital rim divide the temple into 4 parts (A, B, C, and D). The probabilities of the STA, MTA, ZOA, and PDTA appearing in parts A, B, C, and D were 30.73%, 37.06%, 39.48%, and 77.18%, respectively. In 3D images, these vessels together compose an arterial network that is anastomosed with other vessels, such as the external carotid, facial, and ocular arteries. Conclusions 3D CT images can digitally elucidate the exact positions of temporal vessels in a coordinate system, improving the safety of temple filler injections in a clinical setting.

Three-Dimensional Computed Tomographic Study on the Periorbital Branches of the Ophthalmic Artery: Arterial Variations and Clinical Relevance

2018 ◽  
Vol 39 (10) ◽  
pp. 1109-1117
Author(s):  
Wei-Rui Zhao ◽  
Hai-Bin Wang ◽  
Cheng-En Luo ◽  
Xiang-Xue Kong ◽  
Wen-Feng Zhan ◽  
...  
Keyword(s):  
Ophthalmic Artery ◽  
Carotid Arteries ◽  
Superficial Temporal Artery ◽  
Vascular Complications ◽  
Facial Artery ◽  
External Carotid ◽  
3D Ct ◽  
Cosmetic Procedure ◽  
Filler Injection ◽  
Arterial Variations

Abstract Background Filler injection is a popular cosmetic procedure, but it can entail vascular complications. Periorbital injections have the highest risk within the entire injection area. Objectives The authors sought to systematically screen for periorbital arterial variations prior to treatment. Methods The external carotid arteries of 10 cadaveric heads were infused with adequate lead oxide contrast. The facial and superficial temporal arteries of another 11 cadaveric heads were injected with the contrast in sequential order. Computed tomography (CT) scanning was performed after injection of contrast, and 3-dimensional (3D) CT scans were reconstructed using validated algorithms. Results Three types of periorbital blood vessels were found to derive from the ophthalmic artery, including 30% directly originating from the ophthalmic artery, 65% originating from its trochlear branch, and 5% originating from its supraorbital branch. In the forehead, the ophthalmic artery, originating from the internal carotid arteries, formed anastomoses between the frontal branch of the superficial temporal artery, originating from the external carotid artery, with the deep and superficial branches of the supratrochlear and supraorbital arteries, respectively. The lateral orbit and malar plexus can be classified into 4 types based on the trunk artery: the zygomatic orbital artery (27%), the transverse facial artery (23%), the premasseteric branch of the facial artery (19%), and all 3 contributing equally (31%). Conclusions Postmortem 3D CT can map periorbital arterial variations. The branching pattern of the ophthalmic artery, the ophthalmic angiosome in the forehead, and the distribution of the lateral orbit and malar plexus were identified at high resolution to guide clinical practice.

Iatrogenic Vascular Complications Associated With External Ventricular Drain Placement: A Report of 8 Cases and Review of the Literature

2012 ◽  
Vol 72 (2) ◽  
pp. ons208-ons213 ◽  
Author(s):  
Jennifer Kosty ◽  
Bryan Pukenas ◽  
Michelle Smith ◽  
Phillip B. Storm ◽  
Eric Zager ◽  
...  
Keyword(s):  
Transarterial Embolization ◽  
External Ventricular Drain ◽  
Superficial Temporal Artery ◽  
Vascular Complications ◽  
Temporal Artery ◽  
Vascular Trauma ◽  
Vascular Lesions ◽  
Ventricular Catheter ◽  
Traumatic Aneurysm ◽  
Arteriovenous Fistulas

Abstract BACKGROUND: Placement of an external ventricular drain (EVD) is a commonly performed and often lifesaving procedure. Although hemorrhage is one of the commonest complications associated with the procedure, ventricular catheter–induced vascular injury is rarely reported. OBJECTIVE: To describe 9 cases of EVD-related vascular trauma: 7 arteriovenous fistulas and 2 traumatic aneurysms. METHODS: During a 3-year period, 299 patients had EVDs placed. Eight patients (2.75%), 3 male and 5 female (mean age, 48 ± 20 years), developed vascular lesions associated with EVDs. Six patients developed arteriovenous fistulas and 2 patients developed a traumatic aneurysm. The arterial feeders of 5 superficial draining fistulas arose from the middle meningeal artery, and the arterial feeder of a deep-draining fistula originated from a lenticulostriate artery. One traumatic aneurysm arose from a distal branch of the anterior cerebral artery, and the second from a branch of the superficial temporal artery. Four of the superficial fistulas were treated with transarterial embolization. RESULTS: Two superficial fistulas and the deep-draining fistula resolved spontaneously after EVD removal. The intracranial aneurysm was embolized with Onyx18, and the superficial temporal artery aneurysm was managed conservatively. There were no hemorrhages associated with any of these vascular lesions and no complications after treatment. CONCLUSION: Our data suggest that iatrogenic vascular trauma associated with EVD insertions (2.75%) may be more common than is currently appreciated. Endovascular treatment is effective and may be necessary when these lesions do not resolve spontaneously.

Perfusion CT scanning and CT angiography in the evaluation of extracranial-intracranial bypass grafts

2011 ◽  
Vol 114 (4) ◽  
pp. 978-983 ◽  
Author(s):  
Soenke Langner ◽  
Steffen Fleck ◽  
Rebecca Seipel ◽  
Henry W. S. Schroeder ◽  
Norbert Hosten ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cerebrovascular Disease ◽  
Bypass Surgery ◽  
Superficial Temporal Artery ◽  
Ct Scanning ◽  
Temporal Artery ◽  
Perfusion Ct ◽  
Time To Peak ◽  
Bypass Patency ◽  
Before And After

Object Extracranial-intracranial (EC-IC) bypass surgery remains an important treatment alternative for patients with occlusive cerebrovascular disease. The aim of the present study was to use perfusion CT and CT angiography (CTA) to evaluate cerebral hemodynamics and bypass patency in patients with occlusive cerebrovascular disease before and after EC-IC bypass surgery. Methods Ten patients underwent perfusion CT and CTA before and after bypass surgery. Preoperative and postoperative digital subtraction angiography served as the diagnostic gold standard. An artery bypass was established from the superficial temporal artery to a cortical branch of the middle cerebral artery. Perfusion CT scanning was performed at the level of the basal ganglia. Color-coded perfusion maps of cerebral blood volume, cerebral blood flow, and time to peak were calculated. Results Preoperative perfusion CT showed significant prolonged time to peak and reduced cerebral blood flow of the affected hemisphere. Postoperative neurological deterioration did not develop in any patient. Computed tomography angiography provided adequate evaluation of the anastomoses as well as the course and caliber of the bypass and confirmed bypass patency in all patients. Postoperative perfusion CT showed improved cerebral hemodynamics with a return to nearly normal perfusion parameters. Conclusions Computed tomography angiography is a noninvasive and reliable tool for evaluating patients with EC-IC bypass. Perfusion CT allows monitoring of hemodynamic changes after bypass surgery. The combination of both modalities enables noninvasive anatomical and functional analysis of superficial temporal artery–middle cerebral artery anastomoses using a single CT protocol. Hemodynamic evaluation of patients with occlusive cerebrovascular disease before and after surgery may improve the prediction of outcome and may help identify patients in whom a bypass procedure can be performed.

scholarly journals Traumatic pseudoaneurysm of the superficial temporal artery

2012 ◽  
Vol 2 (2) ◽  
pp. 34
Author(s):  
Suvy Manuel ◽  
Deepti Simon ◽  
Eldhose K. George ◽  
Raghava B. Naik
Keyword(s):  
Early Diagnosis ◽  
English Literature ◽  
Superficial Temporal Artery ◽  
Vascular Complications ◽  
Temporal Artery ◽  
Vascular Injuries ◽  
Prompt Treatment ◽  
Anterior Branch ◽  
First Case ◽  
Traumatic Pseudoaneurysm

Aneurysms of the superficial temporal artery are relatively rare vascular complications following trauma. Two cases of pseudoaneurysm of the anterior branch of the superficial temporal artery, subjected to blunt maxillofacial trauma are presented here. The first case was treated by surgical resection and the second was cured by application of continuous pressure. The review of the English literature has also been included. An awareness of these vascular injuries, despite their infrequency, is necessary to facilitate early diagnosis, proper investigation and prompt treatment.

Cranial burr hole for revascularization in moyamoya disease

1989 ◽  
Vol 71 (2) ◽  
pp. 180-185 ◽  
Author(s):  
Masataka Endo ◽  
Nobuyuki Kawano ◽  
Yoshio Miyasaka ◽  
Kenzoh Yada
Keyword(s):  
Moyamoya Disease ◽  
Cerebral Artery ◽  
Clinical Symptoms ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Burr Hole ◽  
Frontal Region ◽  
External Carotid ◽  
Content Type ◽  
Made In

✓ Currently, superficial temporal artery-middle cerebral artery (MCA) anastomosis, encephalomyosynangiosis (EMS), and encephalo-duro-arterio-synangiosis are used to treat moyamoya disease and are reported to effectively improve ischemic symptoms. All are methods of reversing the flow of blood from the external carotid artery system into the cortical branches of the MCA. As moyamoya disease advances, these operations alone will predictably not correct the deterioration in blood flow in the territory of the anterior cerebral artery. It was noted in a case of moyamoya disease with intraventricular hemorrhage that a burr hole, made in the frontal region for drainage purposes, induced marked neovascularization. Since then, similar frontal burr holes have been made in five juvenile cases of moyamoya disease; this procedure involved making a burr hole in both frontal bones and incising both the dura and the arachnoid membrane. In two cases a frontal burr hole was placed simultaneously with EMS, and in the others the frontal burr hole was made following EMS. The clinical symptoms improved after the frontal burr hole was made, and dynamic computerized tomography revealed improved circulation in the frontal regions. Together with conventional surgical therapy for juvenile cases of moyamoya disease, this operation is considered beneficial both to the circulation in the frontal region and for the protection of frontal brain function.

Intracranial and extracranial multiple arterial dissecting aneurysms in rheumatoid arthritis: A case report

2020 ◽  
pp. 159101992096535
Author(s):  
Ken Uekawa ◽  
Yasuyuki Kaku ◽  
Toshihiro Amadatsu ◽  
Hiroaki Matsuzaki ◽  
Yuki Ohmori ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Coil Embolization ◽  
De Novo ◽  
Superficial Temporal Artery ◽  
Vascular Complications ◽  
Temporal Artery ◽  
Left Internal Carotid Artery ◽  
Parent Artery ◽  
Parent Artery Occlusion ◽  
Dissecting Aneurysms

Objective We describe a case of intracranial and extracranial multiple arterial dissecting aneurysms in rheumatoid arthritis (RA). Case Presentation A 29-year-old man with a medical history of RA since 18 years of age was admitted to our hospital for vomiting, dysarthria, and conscious disturbance. At 23, he underwent ligation of the left internal carotid artery (ICA) with superficial temporal artery to middle cerebral artery anastomosis because of acute infarct of the left hemisphere caused by arterial dissection of the left ICA. During the current admission, computed tomography (CT) revealed subarachnoid hemorrhage, and digital subtraction angiography (DSA) demonstrated dissecting aneurysms of the left intracranial vertebral artery (VA) and right extracranial VA. We diagnosed him with a ruptured dissecting aneurysm of the left intracranial VA and performed endovascular parent artery occlusion on the left VA. For the right unruptured VA aneurysm, we performed coil embolization simultaneously. At 2 weeks after the endovascular treatment, follow-up DSA revealed that multiple de novo dissecting aneurysms developed on the origin of the left VA and left and right internal thoracic arteries. Those aneurysms were treated with coil embolization. Other remaining aneurysms on the left thyrocervical trunk, right transverse cervical artery, and both common iliac arteries were treated by conservative therapy. While continuing medical treatment for RA, the patient recovered and was discharged to a rehabilitation hospital. Conclusion Considering that RA-induced vasculitis can be a potential risk of vascular complications including multiple arterial dissections, physicians should carefully perform endovascular interventional procedures for patients with long-term RA.

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