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Sensitivity of aspiration as a safety test before injection of soft tissue fillers
Author(s) -
Van Loghem Jani AJ,
Fouché James J,
Thuis Job
Publication year - 2018
Publication title -
journal of cosmetic dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.626
H-Index - 44
eISSN - 1473-2165
pISSN - 1473-2130
DOI - 10.1111/jocd.12437
Subject(s) - medicine , soft tissue , surgery , india ink , nuclear medicine , anatomy
Summary Background Embolism due to accidental intra‐arterial injection of a soft tissue filler (STF) can lead to serious complications. Physicians practice aspiration as a safety test before injection to rule out intra‐arterial placement of the needle tip. The value of aspiration as a safety test is evaluated in this study, which also considered the rheological properties of different STFs and their needle dimensions. Methods Aspiration with eleven different needle sizes and 24 different STFs was performed using Ringer's lactate (RL) colored with blue skin marking ink and secondly an empty saline bag containing anticoagulated blood, both pressurized to 150 mm Hg to mimic arterial blood pressure. Time between the start of aspiration and liquid in the needle hub was recorded. Results A total of 340 individual aspiration tests with different STFs and needles were performed, of which 112 yielded true‐positive results within 1‐s and 128 yielded false‐negative results after 10 s. Positive results between one and ten seconds were seen in 101 aspiration tests. Conclusions True‐positive results were seen in 33% of the tests performed with STFs within 1 s of aspiration. Aspiration test results are influenced by needle diameter, needle length, and rheological properties of STFs. Additional safety measures are necessary to further reduce risk of inadvertent intravascular injection of STFs.