title: Novel Technique Using Cyanoacrylate and Local Hemostatic Agents in the Management of High-Risk Exodontia Bleeding in a Patient With a Large Facial Arteriovenous Malformation.
abstract: OBJECTIVE
  This report describes a case of a 32-year-old woman who had been diagnosed with a facial arteriovenous malformation during childhood. Because this patient possessed a major risk of perioperative hemorrhage, the use of several local hemostatic measures was thoroughly explored before routine exodontia.
  
  
  METHODS
  Selective embolization of the right superior thyroid artery was performed intraoperatively and a novel hemostatic technique using a combination of a packing of Gelfoam wrapped in Surgicel was placed within the extraction sites and sealed with SwiftSet.
  
  
  RESULTS
  Local hemostasis was achieved with a novel technique using a combination of cyanoacrylate and local hemostatic agents despite aggressive hemorrhaging after routine exodontia.
  
  
  CONCLUSIONS
  By exploiting the local properties of these agents, local hemostasis can be achieved with this novel technique even in the most challenging cases of vascular anomalies.
authors.affiliation: Consultant, Department of Dental Oncology, Maxillofacial and Ocular Prosthetics, Princess Margaret Cancer Centre, Toronto; Resident, Oral and Maxillofacial Radiology, University of Toronto, Toronto, ON, Canada. Electronic address: jeff.chadwick@uhn.ca.
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Chadwick
authors.affiliation: Site Chief, Department of Medical Imaging; Professor and Division Head, Neuroradiology, Toronto Western Hospital, Toronto, ON, Canada.
authors.forename: Karel
authors.initials: K
authors.lastname: terBrugge
authors.affiliation: Consultant, Department of Dental Oncology, Maxillofacial and Ocular Prosthetics, Princess Margaret Cancer Centre, Toronto; Assistant Professor and Discipline Head, Department of Oral and Maxillofacial Surgery, University of Toronto, Toronto, ON, Canada.
authors.forename: David K
authors.initials: DK
authors.lastname: Lam
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction; D001165:Arteriovenous Malformations / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002483:Cellulose, Oxidized; D003487:Cyanoacrylates / Q000627:therapeutic use*; D004621:Embolization, Therapeutic; D005260:Female; D005781:Gelatin Sponge, Absorbable; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D014057:Tomography, X-Ray Computed; D014081:Tooth Extraction
chemical_list: D002483:Cellulose, Oxidized; D003487:Cyanoacrylates; D006490:Hemostatics; C013695:Surgicel