Intraosseous Embolotherapy of Central Arteriovenous Malformations in the Jaw: Long-Term Experience With 8 Cases
Purpose
To investigate the long-term effects of direct intraosseous histoacryl embolotherapy on central arteriovenous malformations (AVMs) of the jaw.
Materials and Methods
Eight patients with central AVMs of the jaw (3 in the maxilla and 5 in the mandible) were treated with direct intraosseous histoacryl injection. These AVMs exhibited cystic radiolucency, with (n = 5) or without (n = 3) honeycombed component. On angiography, all the AVMs exhibited a large intraosseous nidus with multiple suppliers and drainages. The intraossous lesions were percutaneously punctured with an 18- to 20-gauge needle, and NBCA diluted 30% to 40% with iodized oil was injected during venous compression.
Results
Postembolic arteriograms showed that all the AVMs were completely or nearly completely devascularized after single or multiple injections at the initial treatment. The follow-up period ranged from 3 to 8 years. Two AVMs experienced postembolic curettage and were anatomically cured. Three AVMs were anatomically cured after 1 to 3 sessions of embolotherapy. The other 3 AVMs were clinically cured after 1 (n = 2) to 4 (n = 1) sessions of embolotherapy. There were no procedure-related severe complications.
Conclusions
Direct intraosseous glue embolotherapy can be a simple and safe technique for endovascular management of central AVMs in the jaw and is particularly effective in an emergency. Complete reossification of the intraosseous nidus can be anticipated if a complete occlusion is obtained.
⁎Associate Professor, Department of Oral Radiology, Peking University, School and Hospital of Stomatology, Beijing, China
†Professor and Chairman, Department of Oral Radiology and Center for TMD, Peking University, School and Hospital of Stomatology, Beijing, China
‡Professor, Department of Oral and Maxillofacial Surgery, Peking University, School and Hospital of Stomatology, Beijing, China
§Professor and Vice Chairman, Department of Oral and Maxillofacial Surgery, Peking University, School of Stomatology, Beijing, China
Address correspondence and reprint requests to Dr Liu: Department of Oral Radiology, Peking University School and Hospital of Stomatology, 22 Zhongguancun Nandajie, Haidian District, Beijing 10081, P. R. China
ABSTRACT