Intravascular behavior of cutaneous polynucleotide injectables following intra-arterial exposure.

Polynucleotide (PN) injectables are increasingly used in aesthetic medicine, making a clear understanding of their intravascular behavior essential. We conducted a controlled animal study using a rabbit central ear artery model to evaluate the cutaneous consequences of intra-arterial PN injection, comparing formulations with differing viscosities (Rejuran S, Rejuran HB Plus, and Conjuran) with normal saline and cross-linked hyaluronic acid (HA). Arterial flow dynamics, the presence of persistent emboli at 24 h, clinical ischemia, and histopathologic change were assessed. Among the three formulations, Conjuran (higher-viscosity PN) demonstrated the highest frequency of transient arterial occlusion, followed by Rejuran HB Plus (low-viscosity PN combined with non-cross-linked HA), whereas Rejuran S (high-viscosity PN) exhibited the lowest incidence. Importantly, all PN-related flow disturbances were transient, with no visible transparent emboli detected at 24 h and no clinical ischemia or histopathologic evidence of necrosis, vasculitis, or vasculopathy observed on day 7. In contrast, cross-linked HA resulted in persistent intravascular emboli and extensive tissue necrosis. In conclusion, this study demonstrated transient flow disturbance without persistent embolization or ischemia following intra-arterial exposure to PN in this rabbit ear artery model. Further investigation is warranted to define the underlying mechanisms and to characterize microvascular effects and embolic burden.