Abstract: Objective To explore the effect of intravascular hyaluronidase(HAase) in treating rabbit auricular skin flap ischemia caused by HA induced artery embolism, and to compare the different effect of intravenous thrombolysis and selective intra-arterial thrombolysis with HAase. Methods The auricular skin flap model of 20 μL HA artery emblism were created in twenty-five rabbits and the rabbits were divided into five groups(n=5). Control group: no treatment; IVT-NaCl group: intravenous thrombolysis with saline; IVT-HAase group: intravenous thrombolysis with HAase; IAT-NaCl group:intra-arterial thrombolysis with saline; IAT-HAase group: intra-arterial thrombolysis with HAase. Fluorescein examination was performed 4 hours, 3 days and 7 days after operation. The difference of the area percentage of flap perfusion in the five groups was compared 7 days after operation. Results The mean area percentage of flap perfusion of IAT-HAase group was significantly higher than that in the other four groups(P 0.05). Conclusion The selective intra-arterial thrombolysis with HAase can effectively improve the ischemia of the flap caused by HA induced artery embolism, increase the tissue perfusion, and reduce the necrotic area of the flap. However, the effect of intravenous use of HAase as thrombolytic agent needs further investigation.

Key words: Hyaluronic acid, Artery embolism, Hyaluronidase, Intravenous thrombolysis, Selective intra-arterialthrombolysis