Dr. Ines Verner demonstrates how to map the temporal arteries in minutes. High-definition vascular imaging using Color Doppler allows her to visualize the location and measure the depth of the superficial and deep temporal arteries. To confirm the safe injections, she documents the dermal filler after the procedure using ultrasound.
we are going to demonstrate the visualization the mapping of the temporal arteries so we would like to map the superficial temporal artery and also the deep temporal artery here you can see the temporal area you can see the skin the superficial fat the temporal fat pad and also the temporalis muscle this is already the bone so you can see that here and also i want now to change to the doppler mode the color doppler and with the color doppler there are two vessels one is deep here here in this area so the deep temporal artery is at that area there and also we can actually see here the superficial temporal artery is quite superficial so we can measure this depth here and we will know that the superficial temporal artery is actually at three millimeters depth so if we inject deeper if we inject deeper the filler we are actually not going to enter into that vessel also i want to show that if we move away so i don't want to inject very close to where the deep temporal artery is so i'm not going to inject in that area and i'm going to see if a little bit further away i can still see the deep temporal artery so here again the superficial temporal is there and here at the depths there are no vessels so what i need to do when i inject i need to move away from the area where i saw the deep artery and actually go deeper to the superficial temporal artery now i can just move on and actually inject this area and after i inject it i can actually map again and see whether where the filler is located so i'm going to move away from the area where i sew the deep artery and i'm going to the center of the temporal area and inject deep into the temporal area and then i'm still aspirating just in case but and i'm on the bone but i can move my needle a little bit away from the bone and i can actually inject the filler safely into here so what i can do now is actually check where the filler is so it's here it's actually quite deep you can see it here and a the filler is hypoechogenic so you can actually see the structure it's on the bone it's quite deep in the temporal area also i can check with the doppler here this is the deep temporal it's good and let's see this is the superficial temporal artery there very good pulsation there in conclusion before injecting danger zones like the temporal area which is a real danger zone for actually intravascular injection and actually the risk for blindness because there are a lot of anastomosis there and as we know the there are a lot of connections with the optomic artery which can actually cause blindness as has been reported so if we map this area and if we do this vessel mapping there is actually very very little risk to get this problem to actually have this intravascular injection so it was really making the mapping before injecting the filler where there are no vessels and checking afterwards that the filler is placed correctly you
