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Inadvertent intra‐arterial injection of deoxycholic acid: A case report and proposed protocol for treatment
Author(s) -
Lindgren Aleksandra L.,
Welsh Kathleen M.
Publication year - 2020
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.13214
Subject(s) - deoxycholic acid , medicine , adverse effect , bile acid , surgery , anesthesia , pharmacology
Deoxycholic acid (ATX‐101) is a secondary bile acid that was approved as an injectable drug for the reduction of submental fat. Necrosis, an uncommon but serious adverse event, can occur due to inadvertent superficial injection or intra‐arterial injection of the acid. The management of the intra‐arterial injection of deoxycholic acid has not been well characterized. Here, we discuss methods to decrease the risk of such injections and draw on existing protocols for the inadvertent intra‐arterial injection of sclerotherapy solutions and dermal fillers to propose a safe, practical approach to treatment. A case report is presented of a 42‐year‐old woman who received a deoxycholic acid injection for the correction of submental fullness, which was complicated by the inadvertent intra‐arterial injection of the acid. The adaptation of published treatment protocols for the inadvertent injection of sclerosing solutions and dermal fillers allowed for a good outcome in this patient. The inadvertent intra‐arterial injection of deoxycholic acid is a rare event. The risk of such injections can be reduced with attention to injection technique and can be managed successfully following the adaptation of protocols in the literature for similar events from vascular compromise due to dermal fillers and sclerosing solutions.