Depth and hemodynamics of the angular artery in the pyriform space: A cross-sectional study with Doppler ultrasonography.

Abstract

Purpose: Knowledge of the angular artery (AA) anatomy in the nasolabial fold is essential to prevent necrosis during esthetic procedures. This study aimed to assess the depth and hemodynamics of the AA in the pyriform space using 2-dimensional ultrasonography (USG), as well as color and spectral Doppler imaging.

Materials and methods: This study evaluated AA diameter, epidermis-AA distance (EP-AA), AA-bone distance (AA-BO), systolic velocity, diastolic velocity, pulsatility index, and resistance index. These parameters were analyzed in relation to independent variables, including age, sex, and body mass index (BMI). The study sample consisted of 58 Brazilian participants, with both hemifaces independently assessed by 2 trained examiners. Statistical analyses of the variables were performed with a significance level of 5%.

Results: The EP-AA distance was greater in men (5.8 mm) than in women (4.8 mm, P<0.05). BMI was also found to significantly influence the EP-AA distance (P<0.05). No independent variable affected the AA-BO distance. With respect to AA diameter, only age demonstrated a significant influence (P<0.05), with the diameter decreasing as age increased. Similarly, only age was associated with diastolic and systolic velocities (P<0.05), with each additional year corresponding to a reduction of 0.13 cm/s in diastolic velocity and 0.28 cm/s in systolic velocity.

Conclusion: USG demonstrated that AA depth in relation to the epidermis is greater in men and in individuals with higher BMI. Aging is associated with a reduction in both the diameter of the AA and its diastolic and systolic velocities.