title: An alternative approach to maxillofacial arteriovenous malformations with transosseous direct puncture embolization.
abstract: The management of arteriovenous (AVM) malformations of the jaws is complex and requires an integrated team approach. Subspecialists, such as maxillofacial surgeons, interventional radiologists, and critical care intensivists, are commonly involved in the management of these patients. The current treatment options for maxillofacial AVMs are surgical resection combined with endovascular embolization. Surgical treatment of arteriovenous malformations has been associated with significant morbidity and mortality due to potential for massive blood loss. In the pediatric population extensive resection of the craniofacial skeleton may be associated with growth disturbance, functional compromise, and cosmetic deformity. We report a novel technique using endovascular embolization via direct transosseous puncture for a high-flow vascular malformation, obviating the need for extensive surgical resection, and review the important clinical aspects of these life-threatening lesions.
authors.affiliation: Oral and Maxillofacial Surgery, University of Pennsylvania Medical Center, Philadelphia, USA. kademani@yahoo.com
authors.forename: Deepak
authors.initials: D
authors.lastname: Kademani
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Costello
authors.forename: Douglas
authors.initials: D
authors.lastname: Ditty
authors.forename: Peter
authors.initials: P
authors.lastname: Quinn
mesh_terms: D001165:Arteriovenous Malformations / Q000628:therapy*; D002648:Child; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D008437:Maxilla / Q000098:blood supply*; D008438:Maxillary Artery / Q000002:abnormalities*; D008443:Maxillary Sinus / Q000098:blood supply; D006472:Oral Hemorrhage / Q000628:therapy; D011142:Polyvinyl Alcohol / Q000627:therapeutic use; D011677:Punctures / Q000295:instrumentation / Q000379:methods*
chemical_list: D006490:Hemostatics; D011142:Polyvinyl Alcohol