title: Absolute Ethanol Embolisation of Mandibular Arteriovenous Malformations Following Direct Percutaneous Puncture and Release of Coils via a Microcatheter.
abstract: OBJECTIVE
  To evaluate the safety, efficacy, and medium-term outcome of a modified technique of ethanol embolisation of mandibular arteriovenous malformations (AVMs) following a direct percutaneous transvenous approach to the release of coils via a microcatheter.
  
  
  METHODS
  From January 2012 to July 2014, 18 consecutive patients (mean age 20.9 years [range 10-35 years]) with symptomatic AVMs of the mandible were enrolled. A microcatheter was inserted into the lesion via a direct percutaneous puncture needle. Electrolytically detachable coils and 0.018 mm coils were super-selectively placed to decrease the flow and volume of the arteriovenous fistulas via a microcatheter. Absolute ethanol was injected to obliterate the fistulas. Clinical follow-up was performed in all patients. Therapeutic outcomes were determined by evaluating the degree of devascularisation at follow-up angiography and symptoms and signs.
  
  
  RESULTS
  Transvenous release of coils combined with absolute ethanol embolisation were used in all cases. The amount of ethanol used ranged from 5 to 50 mL (mean 25.7 mL) in a single session. Sixteen of 18 patients were cured, and two had partial remission. Follow-up times ranged from 8 to 26 months (medium 15.7 months), and there was no angiographic recurrence of the lesions. Minor complication occurred in five of the 18 patients. There were no major complications.
  
  
  CONCLUSIONS
  Absolute ethanol embolisation following a direct percutaneous transvenous approach to release coils via a microcatheter is a feasible, safe, and highly effective method for the management of mandibular AVMs.
authors.affiliation: Department of Interventional Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Department of Oral and Maxillofacial Surgery, First Affiliated Hospital and Faculty of Dentistry, Harbin Medical University, No. 23 Youzheng Street, Harbin, PR China.
authors.forename: D
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Interventional Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
authors.forename: L
authors.initials: L
authors.lastname: Su
authors.affiliation: Department of Interventional Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
authors.forename: Y
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Interventional Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
authors.forename: Z
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Interventional Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
authors.forename: L
authors.initials: L
authors.lastname: Zheng
authors.affiliation: Department of Interventional Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China. Electronic address: fanxindong@aliyun.com.
authors.forename: X
authors.initials: X
authors.lastname: Fan
mesh_terms: D000293:Adolescent; D000328:Adult; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000628:therapy*; D002648:Child; D000072226:Computed Tomography Angiography; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D000431:Ethanol / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000098:blood supply*; D008904:Miniaturization; D011677:Punctures; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D062666:Vascular Access Devices; D055815:Young Adult
chemical_list: D000431:Ethanol
keywords: Absolute ethanol; Arteriovenous malformations; Coils; Embolisation; Mandible