Ethanol Embolization of Arteriovenous Malformations of the Mandible

Abstract

BACKGROUND AND PURPOSE: Absolute ethanol was reported as an effective embolization of arteriovenous malformations (AVMs), but its use to treat AVMs in the mandible is not yet well established. Here, we present our clinical experience on treatment of mandibular AVMs with absolute ethanol.

Head and Neck Arteriovenous Malformations: Results of Ethanol Sclerotherapy

“…16 The diagnosis "AVM" possibly includes subsets with diverse biologic behavior, and lesion angioarchitecture may predict response to treatments. For example, AVMs with a dilated venous fistula within the mandible or maxilla may respond to several approaches that target the intraosseous venous structure 20,[22][23][24][25][26] ; soft-tissue lesions with diffuse architecture are the most difficult to treat. 21 For the head and neck area, 2 studies on auricular AVMs report success rates for complete nidus devascularization of 18% 18 and 75%.…”

“…Although most complications from ethanol sclerotherapy heal without long-standing functional damage, a serious risk remains for permanent or major complications, reported at 0%-26% frequency per patient. [10][11][12][13][14][15][16][17][18][19][20] Direct interpretation of these figures is difficult because classification of complications between series differs. For example, some include in major complications any event that requires hospitalization for Ͼ48 hours, including those that resolve completely with or without treatment, 14 while others may record as major complications only events that leave a per-manent disturbance.…”

“…29 The most common complication of ethanol sclerotherapy is local skin or mucosal surface necrosis. [10][11][12][13][14][15][16][17][18][19][20] 37 Other possible systemic effects of ethanol include intravascular hemolysis 38 and bronchospasm. 39 Our complication rate was in line with rates in other studies.…”

“…39 Our complication rate was in line with rates in other studies. [10][11][12][13][14][15][16][17][18][19][20] All permanently visible complications included scarring after skin necrosis (n ϭ 5) and local loss of cutaneous hair (n ϭ 2). In retrospect, 3 of our skin/mucosal complications (1 in an upper lip, 1 in a lower eyelid, 1 in a scalp) probably resulted from an injection not sufficiently selective during treatment of a superficial AVM and might have been avoidable.…”

Arteriovenous malformation of the oral cavity: a case report

“…Some studies have reported positive results when combined with surgical treatment, however more research is needed to determine the role of agents these in conventional treatment. Ethanol embolization of AVMs via direct puncture has been reported in several cases with some success, however in high-flow AVMs, ethanol can quickly wash through toward the venous side, losing its thrombogenic properties [20]. Minor complications such as skin and transient peripheral nerve injuries have also been documented [21].…”