Clinical features associated with HFUS-defined vascular occlusion after hyaluronic acid facial injections: a retrospective exploratory study.

Hyaluronic acid (HA) filler injections are widely used in aesthetic treatments but can cause vascular occlusion. Early diagnosis is often delayed due to reliance on clinical experience. High-frequency ultrasound (HFUS) offers a noninvasive diagnostic method. The study aims to explore the association between clinical warning signs and HFUS-defined vascular occlusion after HA filler injections. This retrospective study analyzed 57 patients with suspected vascular occlusion after HA filler injections. HFUS and a clinical scoring system covering seven symptom categories were used for early evaluation. Occlusion and non-occlusion groups were compared using HFUS and clinical scores. Among 57 clinically suspected cases, 42 (73.7%) were classified as HFUS-defined vascular occlusion and 15 (26.3%) were classified as non-occlusion. In multivariable analysis, skin color change (OR 30.390, 95% CI: 2.482-372.039; p = .008) and delayed capillary refill time (OR 185.936, 95% CI: 2.638- 13,095.200; p = .016) were associated factors of vascular occlusion. A two-variable model incorporating there two features yielded an AUC of 0.944 (95% CI: 0.891-0.998). Skin color change and delayed capillary refill time were associated with HFUS-defined vascular occlusion in this exploratory cohort. These findings may help inform clinical assessment but require prospective validation in independent populations.