Yeh C-H, Wu Y-M, Chen Y-L, Wong H-F
Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung, Taiwan.
Interv Neuroradiol. 2012 Dec;18(4):484-9. doi: 10.1177/159101991201800415. Epub 2012 Dec 3.
We describe our experience of the development of contralateral de novo intraosseous AVMs in a ten-year-old girl with AVMs of the mandible who underwent endovascular embolotherapy. She initially presented with intermittent oral bleeding. Computed tomography and digital subtraction angiography demonstrated intraosseous AVMs within the right mandible. The AVMs were treated by transosseous direct-puncture and transarterial embolization with Guglielmi detachable coils and n-butyl cyanoacrylate glue. However, de novo intraosseous AVMs developed within the previously healthy contralateral mandible and resulted in dangerous oral bleeding. Therefore, we suggest regular follow-up and prompt retreatment of any residual mandibular AVMs in patients undergoing endovascular or surgical treatment to prevent subsequent development of "secondary" AVMs and life-threatening oral bleeding.
我们描述了一名患有下颌骨动静脉畸形（AVM）的10岁女孩在接受血管内栓塞治疗后对侧出现新生骨内AVM的情况。她最初表现为间歇性口腔出血。计算机断层扫描和数字减影血管造影显示右侧下颌骨内有骨内AVM。通过经骨直接穿刺并用Guglielmi可脱性弹簧圈和正丁基氰基丙烯酸酯胶进行经动脉栓塞治疗这些AVM。然而，在之前健康的对侧下颌骨内出现了新生骨内AVM，并导致了危险的口腔出血。因此，我们建议对接受血管内或手术治疗的患者进行定期随访，并对任何残留的下颌骨AVM及时进行再治疗，以防止随后出现“继发性”AVM和危及生命的口腔出血。
