Embolization as the Primary Treatment for Mandibular Arteriovenous Malformations: An Analysis of 50 Literature Reports and of an Illustrative Case

• Published in: Journal of oral and maxillofacial surgery Vol. 76; no. 8; pp. 1695 - 1707
• Main Authors: Monteiro, João Luiz Gomes Carneiro, de Arruda, José Alcides Almeida, Figueiredo Leal, Jefferson Luiz, Batista, Laécio Leitão, Célia de Aguiar Soares Carneiro, Suzana, do Egito Vasconcelos, Belmiro Cavalcanti
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2018
• Subjects: Adolescent; Arteriovenous Malformations - diagnosis; Arteriovenous Malformations - therapy; Dentistry; Diagnostic Imaging; Embolization, Therapeutic - methods; Humans; Male; Mandible - blood supply
• ISSN: 0278-2391; 1531-5053
• DOI: 10.1016/j.joms.2018.02.013

The aim of the present report is to describe 50 cases in the literature of mandibular arteriovenous malformations (AVMs) in which embolization was the primary treatment and to discuss details such as age, gender, materials used, outcome of embolization, time of follow-up, and intra- or postprocedure complications. An illustrative case in which reossification was noticed after embolization also is presented.
The study was carried out in 2 steps. In the first, an electronic search without time restriction for embolization as the primary treatment for mandibular AVMs was performed on Medline through PubMed. In the second, the case of a patient with mandibular AVM and massive oral bleeding episodes is described after a long-term follow-up.
Clinical stability with the cessation of oral bleeding episodes was detected in 25 cases and 2 cases were planned for another embolization session. Clinical stability and reossification were detected in 23 of the 50 cases included. Complications were reported in 50% of cases, but most were minor and transient.
Currently, owing to more sophisticated imaging techniques, the diagnosis of mandibular AVMs is quicker and new, less invasive techniques that avoid surgical resection have proved effective. It should be emphasized that these techniques are not without complications and that long-term monitoring is extremely important.