Intraosseous embolotherapy of central arteriovenous malformations in the jaw: long-term experience with 8 cases.
OBJECTIVE
To investigate the long-term effects of direct intraosseous histoacryl embolotherapy on central arteriovenous malformations (AVMs) of the jaw.


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 intraosseous 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.
Liu
Denggao
D
Department of Oral Radiology, Peking University, School and Hospital of Stomatology, Beijing, China. kqldg@bjmu.edu.cn
Ma
Xuchen
X
Zhao
Fuyun
F
Zhang
Jianguo
J
D000293:Adolescent; D000328:Adult; D000792:Angiography; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000628:therapy*; D002342:Carotid Artery, External / Q000002:abnormalities*; D002343:Carotid Artery, Internal / Q000002:abnormalities; D002648:Child; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017148:Infusions, Intraosseous; D008297:Male; D008334:Mandible / Q000098:blood supply / Q000000981:diagnostic imaging; D008437:Maxilla / Q000098:blood supply / Q000000981:diagnostic imaging; D014014:Tissue Adhesives / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
D014014:Tissue Adhesives; D004659:Enbucrilate