China Journal of Oral and Maxillofacial Surgery ›› 2024, Vol. 22 ›› Issue (1): 78-83.doi: 10.19438/j.cjoms.2024.01.014

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Long term efficacy analysis of interventional embolization treatment for intraosseous arteriovenous malformations of the jaw

LI Xiao1, WANG Hao-wei1, YANG Xi-tao2, WANG De-ming2, FAN Xin-dong2, SU Li-xin2   

  1. 1. The 2nd Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology. Shanghai 200011;
    2. Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2023-01-15 Revised:2023-09-11 Online:2024-01-20 Published:2024-02-05

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Abstract: PURPOSE: To explore the effectiveness and safety of interventional embolization for the treatment of intraosseous arteriovenous malformations (AVMs) in the jaw. METHODS: A retrospective study was conducted to analyze a total of 9 patients with intraosseous AVMs in the jaw bone who were treated at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Under the guidance of DSA, interventional embolization was performed to observe the lesion and predict the injection dose of sclerosing agents. The efficacy, adverse reactions and complications of patients were observed in a long-term follow-up. RESULTS: This study included 9 patients with intraosseous AVMs in the jaw, including 6 male patients (66.7%) and 3 female patients(33.3%), aged 7-51 years, with an average age of 21.3 years. Bleeding was the main reported symptom of patients, accounting for 66.7% of all cases. The blood supply arteries involved in this study included the branches of the inferior alveolar artery, facial artery, and maxillary artery. Nine cases of jaw bone AVMs were treated with interventional embolization under general anesthesia for a total of 20 times (each patient received 1-5 times, with an average of 2.2 times per person). The average single application dose of absolute ethanol was 21.95 mL. Among the 20 interventional embolization treatments, 9 were treated with coil assisted ethanol embolization, with a total of 158 coils used, with an average of 17.6 coils per treatment(80 coils per 9 treatments). Another 2 used bleomycin and 5 used a small amount of 150 μm PVA particles as auxiliary embolization therapy. Among the 9 cases of jaw bone AVMs included in this study, 4 were cured, 3 were basically cured, and 2 had improvement. The effective rate of treatment was 100%. CONCLUSIONS: In the treatment of intraosseous AVMs of the jaw, correct diagnosis based on clinical and imaging manifestations, and the use of ethanol embolization based on DSA imaging results can reduce trauma, improve symptoms, control lesions, and achieve relatively satisfactory treatment results. This treatment plan is safe and effective.

Key words: Jaw bone, Arteriovenous malformations, Interventional embolization therapy, Coil, Absolute ethanol

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